What is Diabetic Nephropathy?

Diabetic Nephropathy: Symptoms, Causes, Treatment and Prevention

Diabetic nephropathy is a significant health concern that affects millions of people worldwide, especially those with type 1 or type 2 diabetes. It is a progressive condition that can cause significant damage to the kidneys and ultimately lead to kidney failure. The kidneys play a vital role in filtering waste products and excess fluids from the body, and when they are not functioning correctly, waste products can build up, leading to a range of health problems. 

High blood sugar levels over an extended period can cause damage to the blood vessels in the kidneys, which can lead to decreased kidney function and the development of proteinuria, a condition where protein leaks into the urine. If left untreated, diabetic nephropathy stages can progress to end-stage renal disease, requiring dialysis or a kidney transplant. With early detection and proper management, people with diabetic nephropathy can improve their quality of life and reduce the risk of serious complications.

Let’s explore the causes, symptoms, diagnosis, and treatment options available for diabetic nephropathy, as well as provide advice on how to prevent or delay its onset. 

Diabetic nephropathy symptoms

In the early stages of diabetic nephropathy, symptoms may be absent or mild, making it challenging to detect. However, as the diabetic kidney disease stages progresses various symptoms can can be seen, such as:

  • Swelling in the feet, ankles, and legs
  • High blood pressure
  • Frequent urination
  • Difficulty sleeping
  • Nausea and vomiting
  • Loss of appetite
  • Fatigue and weakness
  • Worsening blood pressure control
  • Protein in the urine
  • Swelling of feet, ankles, hands, or eyes
  • Increased need to urinate
  • Reduced need for insulin or diabetes medicine
  • Confusion or difficulty concentrating
  • Shortness of breath
  • Persistent itching

Causes of diabetic nephropathy

Causes of diabetic nephropathy include high blood sugar levels over an extended period, which can damage the small blood vessels in the kidneys and decrease their efficiency in filtering waste products from the blood. Poorly controlled diabetes can cause damage to blood vessel clusters called glomerulus in the kidneys that filter waste from the blood, leading to kidney damage and high blood pressure. Hypertension, a complication of diabetes, can directly contribute to diabetic nephropathy and cause further kidney damage by increasing pressure in the filtering system. Uncontrolled hypertension can accelerate the progress toward stage five chronic kidney disease.

Diagnosis of diabetic nephropathy

The diagnosis of diabetic nephropathy involves several tests to determine kidney damage.

Diabetic Nephropathy1

  • Urine tests: These are conducted to check the presence of protein, an early sign of kidney damage.
  • Blood tests: To measure creatinine levels to evaluate kidney function.
  • Imaging tests: Tests such as an ultrasound or CT scan may be used to check for physical abnormalities in the kidneys.
  • Annual urine testing: This is recommended for individuals with diabetes to detect diabetic nephropathy in an early stage.

Early diagnosis and treatment can slow the progression of kidney damage and prevent kidney failure.

Diabetic nephropathy treatment

Specific treatment for diabetic nephropathy will be determined by a doctor based on various factors, including age, overall health, and medical history. A combination of treatment options may be used to manage the condition and improve  kidney function. The treatment of diabetic nephropathy depends on the severity of the condition. In the early stages, treatment aims to slow down the progression of the disease by controlling blood sugar levels, blood pressure, and cholesterol levels through medication and lifestyle changes. This includes proper diet, exercise and strict monitoring and controlling of blood glucose levels, often with medication and insulin injections. Maintaining a lower blood pressure and blood sugar control can slow down the progression of diabetic nephropathy. 

If left untreated, diabetic nephropathy can lead to advanced kidney failure, requiring treatment with dialysis or a kidney transplant. 

Risk factors of diabetic nephropathy

Here are some of the risk factors and potential complications associated with diabetic nephropathy:

  • Uncontrolled high blood sugar (hyperglycemia)
  • Uncontrolled high blood pressure (hypertension)
  • Smoking
  • High blood cholesterol
  • Obesity
  • A family history of diabetes and kidney disease

Complications of diabetic nephropathy

Some complications of diabetic nephropathy includes:

  • Fluid retention leading to swelling in arms and legs, high blood pressure, or fluid in lungs
  • High potassium levels in blood (hyperkalemia)
  • Cardiovascular disease, leading to stroke
  • Damage to the blood vessels of the eye’s light-sensitive tissue (diabetic retinopathy)
  • Anemia caused by reduced number of red blood cells
  • Foot sores, erectile dysfunction, diarrhea, and other problems related to damaged nerves and blood vessels
  • Bone and mineral disorders due to inability of the kidneys to maintain calcium and phosphorus balance in blood
  • Pregnancy complications for both mother and developing fetus
  • Irreversible damage to kidneys (end-stage kidney disease) requiring dialysis or kidney transplant for survival

Did you know diabetic nephropathy carries high morbidity and mortality?

How to prevent diabetic nephropathy?

Some of the most effective ways to prevent diabetic nephropathy are:

  • Maintain good blood sugar control: Keeping blood sugar levels in the target range is the most effective way to prevent diabetic nephropathy. Regular monitoring of blood sugar levels and taking medications as prescribed by the doctor is essential to maintain good control.

Diabetic Nephropathy2

  • Control high blood pressure: High blood pressure can cause damage to the kidneys over time. It is important to monitor blood pressure regularly and take medications as prescribed by the doctor to keep it under control.
  • Manage a healthy weight: Being overweight or obese increases the risk of developing diabetic nephropathy. Losing weight through a healthy diet and regular physical activity can help prevent the condition.
  • Follow a healthy diet: Eating a diet low in saturated fats, cholesterol, and sodium and rich in fruits, vegetables, whole grains, and lean protein can help prevent diabetic nephropathy. Foods to avoid with kidney disease and diabetes include processed and packaged foods, sugary drinks, red meat potatoes and processed and refined grains.
  • Quit smoking: Smoking damages blood vessels and increases the risk of developing diabetic nephropathy. Quitting smoking can help prevent the condition.
  • Regular checkups: Regular checkups with the doctor to monitor blood sugar levels, blood pressure, and kidney function can help detect and prevent diabetic nephropathy at an early stage.

Lastly, diabetic nephropathy can have a negative impact on real people and their loved ones. The fear of losing one’s kidneys and the possibility of a life dependent on dialysis or transplantation can be emotionally draining. Let’s not forget that this condition does not have to define your life. By taking proactive steps and managing your health, you can overcome the challenges posed by diabetic nephropathy. Don’t be afraid to reach out to your loved ones for support or to your doctor for guidance. With the right mindset, care, and support, we can beat this condition and live our lives to the fullest.

About Author –

Dr. Mamidi Pranith Ram,Consultant Nephrologist and Renal Transplant Physician, Yashoda Hospitals - Hyderabad
MBBS, MD, DM (Nephrology)

The best nephrologist in hyderabad

Dr. Mamidi Pranith Ram

MBBS, MD, DM (Nephrology)
Consultant Nephrologist and Renal Transplant Physician

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