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Diabetic Nephropathy

Last Updated February 2024 | This article was created by editorial staff and reviewed by Kyle Bradford Jones, MD, FAAFP

Table of Contents

What is diabetic nephropathy?

Diabetic nephropathy is a complication of diabetes and affects the kidneys. In healthy kidneys, many tiny blood vessels filter waste products from your body. These blood vessels have holes that are big enough to allow tiny waste products to pass through into the urine. But the blood vessels are still small enough to keep useful products (such as protein and red blood cells) in the blood. High levels of sugar in the blood can damage these vessels if diabetes is not controlled. This can cause kidney disease, which is also called nephropathy. If the damage is bad enough, your kidneys could stop working.

Symptoms of diabetic nephropathy

Diabetic nephropathy does not usually cause any symptoms until kidney damage is severe. As the condition progresses, symptoms can include the following:

  • Swelling of the feet and ankles
  • Weakness
  • Loss of appetite
  • Upset stomach
  • Insomnia and difficulty sleeping
  • Confusion and trouble thinking

What causes diabetic nephropathy?

Diabetic nephropathy is a complication of diabetes. Over time, high levels of sugar can damage kidneys. Kidney damage is more likely if your blood sugar is uncontrolled, and your diabetes is not managed. It is also more likely if you smoke or if you have high blood pressure. Diabetic nephropathy is more common in people who are African American, Mexican American, or Native American, according to the National Institutes of Health.

How is diabetic nephropathy diagnosed?

Your doctor will test your urine for protein. If there is protein in your urine, this could mean that your diabetes has damaged the holes in the blood vessels of your kidneys. This makes the holes big enough for protein (and other nutrients your body needs) to leak into your urine. Your doctor may also want to do a blood test to see how much damage has been done to the kidneys.

Can diabetic nephropathy be prevented or avoided?

The best way to prevent diabetic nephropathy is to keep your blood sugar regulated. You should also regularly check your blood pressure. High blood pressure can lead to a decrease in kidney function. Keeping blood pressure in the normal range can help prevent damage to your kidneys.

Diabetic nephropathy treatment

If you have been diagnosed with diabetic nephropathy, you cannot reverse the damage, but you can slow it. Here are some of the most important things you can do to protect your kidneys:

  • Keep your blood pressure lower than 140 over 90. High blood pressurecan speed up damage to the kidneys. Your doctor may give you medicine to help lower your blood pressure.
  • Control your blood sugar level. Take your diabetes medicines and/or insulin exactly as your doctor prescribes.
  • Stick to a healthy diet. People who have diabetic nephropathy may need to eat less protein.
  • Be physically activeevery day.
  • Stop smoking.
  • Check with your doctor before taking any new medicines. This includes vitamins, herbal medicines, and over-the-counter medicines.
  • Keep your doctor appointments.

Even with the right treatments, diabetic nephropathy can get worse over time. Your kidneys could stop working. This is called kidney failure. If this happens, waste products build up in your body. This can cause nausea, vomiting, weakness, shortness of breath, and confusion. In severe cases, kidney failure can cause seizures and coma.

If you have kidney failure, your doctor will refer you for dialysis. In dialysis, a machine is used to take waste products out of the blood. One kind of dialysis must be done in a clinic. For another kind of dialysis, the machine is so small you can strap it to your body while you go about your daily activities. If you develop kidney failure, your doctor will help you decide which type of dialysis machine is right for you.

Living with diabetic nephropathy

Receiving treatment early can slow or even stop diabetic nephropathy from advancing. The disease progresses slowly. Not everyone who develops diabetic nephropathy will reach the stage of kidney failure. Having diabetes does not mean you will develop the disease.

Questions to ask your doctor

  • I have diabetic nephropathy. Could my kidneys fail?
  • Will I need dialysis for my kidneys?
  • Are there any medicines that I shouldn’t take?
  • Could herbal supplements be dangerous for me?
  • What is the best thing I can to prevent further damage to my kidneys?
  • Are there any medicines that I can take to help prevent damage to my kidneys?


American Diabetes Association

National Institutes of Health, MedlinePlus: Diabetes and Kidney Disease

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