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Diabetic Nephropathy - Symptoms, Diagnosis, Treatment and Prevention

Published on Jun 24, 2022   -  5 min read


The nephron is the filtering unit of the kidney, and diabetic nephropathy is a disease of the nephron that results from type 1 and 2 diabetes mellitus.


What Is Diabetic Nephropathy?

Diabetic nephropathy is also called diabetic kidney disease. Nephropathy is a condition that affects the kidneys' ability to perform their normal function of removing waste products and extra fluid from the body. The best way to prevent or delay diabetic nephropathy is by efficiently managing diabetes and high blood pressure. The condition develops slowly over the years. Kidney disease can progress to kidney failure, also called end-stage kidney disease, which is a life-threatening condition that requires dialysis or a kidney transplant.

People with diabetes tend to have other medical conditions, like high blood pressure, high cholesterol, and hardening of the blood vessels (atherosclerosis), and thus have a needy prognosis than people with kidney disease alone. People with diabetes also are more likely to have other kidney diseases such as urinary bladder and urinary tract infections. The difference between kidney disease in type 1 and 2 diabetes is that it rarely begins in the first ten years of diabetes in type 1, whereas type 2 diabetes patients already have kidney disease before they are diagnosed with diabetes.

What Are the Symptoms of Diabetic Nephropathy?

How to Diagnose Diabetic Nephropathy?

  1. This test detects the presence of blood and the protein "albumin" in the urine. The kidneys do not filter albumin out of the blood. Therefore, the presence of protein in the urine indicates poor kidney function.

  2. To detect the albumin: creatinine ratio. Creatinine is a waste product that is filtered by the kidneys, and albumin is a protein that is reabsorbed by the kidneys. In renal dysfunction, this ratio is increased as albumin is excreted through urine. Thus, a urine sample will show increased albumin to creatinine ratio.

What Are the Risk Factors of Diabetic Nephropathy?

How to Treat Diabetic Nephropathy?

The diabetic nephropathy treatment should start with treating diabetes and controlling hyperglycemia. Hypertension should be treated effectively. This includes diet, lifestyle changes, exercise, and medications. Management of blood sugar and hypertension may prevent or delay kidney dysfunction and other complications. Overall factors affecting the treatment include- age, overall health, medical history, the extent of the disease, tolerance of the body to specific medications, and various therapies prescribed.

In advanced cases where there is the maximum deterioration of the kidney function, hemodialysis or a kidney transplant is required.

How to Prevent Diabetic Nephropathy?


Early treatment can prevent or slow down the disease progression and reduce the chance of overall complications. Patients with diabetes should give special care to maintaining a diet and healthy lifestyle. Other complications such as blood pressure and cholesterol should be routinely checked and treated as prescribed by the physician. People with diabetes on long-term medications should routinely check for normal kidney function. Smoking and alcohol consumption should be stopped as it worsens the condition. Nephropathy can be treated, thereby preventing kidney failure.


Frequently Asked Questions


What Are the Clinical Features of Nephropathy?

Diabetic nephropathy affects the kidneys and interferes with their normal function (filtration). The signs and symptoms of nephropathy are as follows:

Swelling in feet and ankles.

- Urge to urinate.

- Shortness of breath.

- Confusion.

- Itching.

- Proteinuria.

- Nausea.

- Vomiting.


What Is the Treatment for Diabetic Nephropathy?

Diabetic nephropathy is treated by:

- Lifestyle changes like exercise, diet, and avoiding smoking and alcohol consumption may aid in managing blood sugar and blood pressure levels.

- Anti-hypertensive medications to control blood pressure.

- Anti-diabetic medications such as Metformin to manage blood glucose levels.

- In the advanced stage - Kidney transplants and dialysis are suggested.


How Do I Know the Early Warning Signs of Kidney Disease?

Here are the early warning signs of kidney disease:

- Swelling around the eyes.

- Poor sleep.

- Foamy urine.

- Weakness.

- Poor appetite.

- Swollen feet and ankles.

- Itching.


How Is Diabetic Nephropathy Diagnosed?

The following criteria are used in the diagnosis of diabetic nephropathy:

- First, a urine test is done to examine the albumin in the urine. The high albumin in urine indicates nephropathy.

- Glomerular filtration rate (GFR) is another criterion for evaluating diabetic nephropathy. Low GFR is a sign of kidney disorder.

- The high albumin: creatinine ratio also signifies nephropathy.

In addition, imaging investigations like CT (computed tomography) and MRI (magnetic resonance imaging) are also helpful in diagnosing diabetic nephropathy.


What Is Stage 4 Diabetes?

Stage 4 diabetic kidney disease is a severe condition. The characteristic features of this stage are listed down:

- Swollen feet and hands.

- Frequent urge to urinate.

- High potassium levels in the blood.

- High blood pressure.

- Proteinuria.

The doctor may have regular follow-ups to prevent complications.


Are Diabetic Nephropathy and Kidney Failure the Same?

Diabetic nephropathy is a severe condition that drastically affects the kidney’s function. Usually, the tiny blood vessels in the kidney filter the waste products from the blood. In diabetic nephropathy, the kidney's filters are damaged due to high blood glucose and blood pressure levels. In contrast, kidney failure or end-stage kidney disease (ESRD) marks the final stage of diabetic nephropathy. According to the classification, kidney failure is the fifth stage of diabetic nephropathy.


How Long Does It Take for Diabetic Nephropathy to Develop?

Type 1 and type 2 diabetes is the leading cause of nephropathy. During the initial stages of symptoms, the affected individual does not have any severe symptoms. However, a few functional changes in the kidney may develop in two to five years. However, it takes ten to 30 years for the disease to progress into a severe condition. Therefore, diet, lifestyle modification, and medications to control diabetes and hypertension may prevent complications.


Is Diabetic Nephropathy Life-Threatening?

The progression of the disease into a life-threatening condition called kidney failure or end-stage renal disease (ESRD) takes 10 to 30 years. The risk factors include diabetes, uncontrolled hypertension, smoking, high cholesterol, etc. During end-stage renal disease, the kidney loses its ability to filter waste products. Thus, the toxins accumulate in the body to cause severe complications like fluid retention, cardiovascular disease, etc.


Is Diabetic Nephropathy Reversible?

Diabetic nephropathy is not entirely curable. However, the following measures need to be followed to prevent its progression and complication:

- Maintain blood sugar levels.

- Control blood pressure and cholesterol levels.

- Avoid smoking and alcohol consumption.

- Maintain a proper diet to prevent obesity.

Last reviewed at:
24 Jun 2022  -  5 min read




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