What Is Diabetic Kidney Disease?
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Diabetic Kidney Disease - Causes, Symptoms, Risk Factors, Management and Prevention

Published on Sep 01, 2022   -  4 min read


Diabetic kidney disease is an injury to the renal blood vessels due to an increase in the levels of glucose in the blood occurring in people with diabetes.

What Is Diabetic Kidney Disease?

Kidney disease occurring as a complication of diabetes is called diabetic kidney disease. In this disease, the kidney's filters, the glomeruli, get impaired. Because of the impairment, renal function becomes abnormal. The kidneys lead an unusual amount of protein into the urine called proteinuria. The protein that is mainly excreted in the urine is albumin. A rise in the level of albumin in the urine (albuminuria) indicates kidney damage due to diabetes. Depending upon the albumin lost in the urine, diabetic kidney disease is divided into two categories -

  1. Microalbuminuria - The amount of albumin that is excreted into the urine ranges from 30 to 300 mg per day. It is also called incipient nephropathy.

  2. Proteinuria - Albuminuria more than 300 mg per day. It can also be called macroalbuminuria or overt nephropathy.

What Causes Diabetic Kidney Disease?

The kidney's normal function includes filtration of the blood, regulation of blood pressure, and water and electrolyte balance. A kidney consists of millions of filtering units called nephrons. These nephrons get harmed due to high levels of sugar in the blood. This damage prevents the normal functioning of the kidney and develops leakage of protein and blood into the urine.

Moreover, the raised blood sugar causes the proteins in the glomeruli to link together, called the "cross-linked" proteins. These cross-linked proteins initiate the localized scarring process. This process is called glomerulosclerosis. It takes a long period to develop glomerulosclerosis. The condition worsens when the sclerotic tissue replaces the healthy tissue. Regulation of blood pressure is also hampered in many patients causing high blood pressure (hypertension) and damaging the kidneys.

Chronic kidney disease requires a long time to develop symptoms after diabetes. The long-term duration of diabetes increases the chances of kidney damage. Diabetic kidney disease is more likely to develop when the blood glucose level and blood pressure are too high.

What Are the Symptoms of Diabetic Kidney Disease?

As the condition worsens in chronic kidney disease, the kidneys gradually progress to end-stage renal disease or kidney failure. The first indication of diabetic kidney disease is considered to be microalbuminuria.

  • Microalbuminuria - It is considered to be the first sign of kidney damage. It can persist as microalbuminuria or can progress into proteinuria.

  • Proteinuria - It is an irreversible condition where protein leaks into the urine. It marks a gradual decline in kidney function and end-stage renal disease.

  • Edema - Swelling of the feet, ankles, hands, and eyes. Puffiness around the eyes. Swelling is caused due to fluid retention.

  • Delirium - Confusion or difficulty in concentration.

  • Apnoea - Shortness of breath.

  • Polyuria - Increased need for urination.

  • Anemia - A decrease in circulating red blood cells causes anemia. A feeling of tiredness is felt due to anemia.

  • Electrolyte Imbalance - As the kidney function deteriorates, calcium, phosphate, phosphorus, and magnesium disturb the electrolyte balance. Bone thinning or fractures due to calcium and phosphate imbalance can occur.

What Are the Risk Factors Associated With Diabetic Kidney Disease?

Risk factors in people with diabetes that increase the chances of developing kidney disease are -

  • Tobacco chewing or smoking.

  • Intake of foodstuffs containing sugar.

  • High intake of salt-containing food.

  • Obesity.

  • Presence of heart disease.

  • Family history of kidney failure.

  • Sedentary lifestyle.

  • Unhealthy eating patterns.

  • Patients not following the course of hypoglycemic medications.

How to Treat Diabetic Kidney Disease?

1. To Treat Hypertension -

Angiotensin-converting enzyme inhibitors (ACE) and angiotensin II receptor blockers are the two types of medications used to control high blood pressure. ACE inhibitors work by decreasing the amount of angiotensin II in the bloodstream, which is responsible for constricting the blood vessels. As a result, the blood vessels relax, which further prevents high blood pressure. Angiotensin II receptor blockers can be used in patients allergic to ACE inhibitors.

2. To Control Hyperglycemia -

Hyperglycaemia is an increased level of sugar in the blood. Hypoglycemic medication is prescribed to control the blood glucose level. Good management of glucose levels in the blood can help avoid or delay the progression of kidney diseases, cardiovascular diseases, and stroke.

3. To Control Risk Factors -

Drugs are crucial in controlling cholesterol levels, heart disease, peripheral arterial disease, and stroke. One should adopt healthy lifestyle habits to regulate the worsening of the condition. Maintenance of body weight and regular physical activity help keep a check on secondary complications. Quitting tobacco use in any form should be made as timely as possible.

How to Prevent Diabetic Kidney Disease?

  • People with diabetes should be tested routinely for the presence of any kidney damage, which can prevent or delay kidney damage and end-stage renal disease. Once diabetic kidney disease has been diagnosed, people with diabetes should take steps to prevent it from worsening.

  • Kidney damage is inconceivable to get worse when the blood sugar level and blood pressure level is under control. To control blood pressure, regular physical activity, weight loss, reduction in salt intake, limiting alcohol intake, and quitting smoking may have to be done. Drugs like ACE innovators can be prescribed by the physician to lower blood pressure. Following the course of medication can keep a check on high blood pressure.

  • Lifestyle changes need to be done with a workout diet plan. It can help in preventing obesity. A reduction in salt and protein intake is suggested.

  • Bladder or kidney infections can present signs and symptoms like burning sensation during urination, a frequent urge to urinate, reddish urine, fever, and pain in the back.

  • Avoid the consumption of painkillers like Aspirin. Aspirin and other painkillers can make kidney damage worse. Such painkillers should be taken only after consulting a physician. Too many painkillers can increase the risk of kidney damage.

  • The presence of other medical conditions like heart disease, liver disease, and high cholesterol level needs medical attention.


Every patient who has diabetes does not develop kidney disease. Regularly testing the sugar levels help early diagnosis of chronic kidney disease. Early treatment with diabetes is most effective and can help prevent other medical conditions. Managing blood sugar levels, blood pressure, and cholesterol levels reduce the risk factors for heart disease and stroke. People with prediabetic situations can avoid the occurrence of type II diabetes mellitus, which is a vital step in precluding renal disorders.

Frequently Asked Questions


What Are the Signs of Diabetic Kidney Disease?

The signs of diabetic kidney disease are microalbuminuria, proteinuria, delirium, edema, polyuria, apnoea, electrolyte imbalance, and anemia. However, microalbuminuria is the first indication of diabetic kidney disease.


Can Diabetic Kidney Disease Be Cured?

There is no specific cure for diabetic kidney disease. The treatment involves steps to delay and stop the progression of the condition. The treatment consists of medications to control high blood sugar levels, management of hypertension, and lifestyle modifications.


Is Diabetic Kidney Disease A Serious Condition?

Diabetic kidney disease is a serious complication that occurs in people with diabetes. Sometimes the kidneys become diseased in diabetic patients resulting in diabetic kidney failure. This condition needs emergency treatment to control glucose levels and high blood pressure to prevent the incidence of complications such as stroke and heart disease.


What Is End-Stage Diabetes?

Prolonged diabetes can lead to advanced complications and end-stage diabetes. People with diabetes develop advanced complications like renal failure, coronary artery disease, albuminuria, peripheral neuropathy, heart failure, and stroke after living with diabetes for many years. This advanced stage of complications is commonly called end-stage diabetes.


How Can We Treat Diabetic Kidney Disease?

Diabetic kidney disease can be managed by controlling hyperglycemia and hypertension. Hyperglycemia can be managed using hypoglycemic medications like Insulin and oral hypoglycemic drugs. Hypertension can be treated with angiotensin II receptor blockers and angiotensin-converting enzyme inhibitors (ACE).


How Can Someone Reduce Microalbuminuria?

Microalbuminuria can be reduced by using medications like angiotensin II receptor blockers (Losartan) and angiotensin-converting enzyme inhibitors (Lisinopril), hypoglycemic drugs, other hypertension medications, and lifestyle modifications. In microalbuminuria, a small amount of albumin protein is present in the urine.


Can Albuminuria Be Reversed?

Albuminuria is an indication of kidney disease and is characterized by the presence of albumin in the urine. Albuminuria can be reduced to a certain extent by taking medications to lower blood pressure and also by lifestyle modifications. People with albuminuria must reduce the intake of food items with high salts and try to maintain optimal weight.


Does Eating Too Much Protein Cause Microalbuminuria?

Studies have shown an increased incidence of proteinuria or albuminuria in people with high protein intake. Intake of a high-protein diet for a long period of time causes intralobular hypertension and kidney hyperfiltration resulting in glomerular injury and proteinuria. The quality of the ingested dietary protein also plays a significant role in kidney health.


What Are the Most Common Causes of Proteinuria?

Proteinuria involves high levels of protein in the urine. The common causes of proteinuria are immune disorders, kidney disease, dehydration, high stress, inflammation, fever, high blood pressure, kidney stones, Aspirin, diabetes mellitus, cancer, preeclampsia, glomerulonephritis, chronic kidney disease, and cardiovascular diseases.


Is Proteinuria a Serious Condition?

In proteinuria, there will be increased levels of protein in the urine. Persistent proteinuria is a serious condition and may increase the risk of cardiovascular diseases and heart attacks. Proper treatment for the underlying cause of proteinuria is essential to prevent complications. It involves the treatment of hypertension, kidney diseases, and diabetes mellitus.

Last reviewed at:
01 Sep 2022  -  4 min read




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