Diabetic Nephropathy: What You Need to Know

Diabetes is a complex condition that comes with a host of potential complications. People who suffer from diabetes are at increased risk for a variety of other serious conditions, including heart disease and stroke. While this can be intimidating and frightening, one of the most important things you can do for yourself is to understand these risks, so you know how best to prevent them.

One such risk is diabetic nephropathy, or kidney damage. While not everyone who has diabetes will experience diabetic nephropathy, about 40% of people with diabetes will develop nephropathy over time. Further, it can be extremely serious, leading to kidney failure. In fact, according to HealthLine, more than 40% of kidney failure cases are the result of diabetes-related complications.

So, we’re here to help you understand the causes and symptoms of nephropathy, and hopefully put you on the path to mitigating your chances of developing this dangerous condition.

What causes diabetic nephropathy?

Kidneys perform the crucial function of filtering waste, excess water, and salt from the blood. In properly functioning kidneys, millions of tiny holes within the capillaries (tiny blood vessels) are responsible for this filtering system. As blood flows through the blood vessels, the waste is filtered through the holes and excreted as urine. The things the body needs (i.e. protein) are retained in the blood.

Uncontrolled blood glucose levels can damage the blood vessels, causing the filtration system to fail. When this occurs, the useful things the body should be retaining, like protein, begin to leak into the urine.

a man checks his aching foot

What are the symptoms of nephropathy?

Nephropathy is often asymptomatic in its early stages. However, regular appointments with your doctor are crucial as urine tests can help catch it before it has become advanced. They can also gather information from your blood pressure, blood tests, and the function of other organs. If caught early enough, the damage can sometimes be reversed.

Later symptoms include:

  • High blood pressure
  • Loss of sleep
  • Swelling in your body, especially feet and legs
  • Loss of appetite
  • Nausea
  • Itchy/dry skin
  • Headache
  • Upset stomach
  • Trouble concentrating
  • Weakness

What are the complications of diabetic nephropathy?

As nephropathy worsens, it can develop into chronic kidney disease, then kidney failure. At this point, the condition is life-threatening, and treatment options become limited to dialysis or a kidney transplant.

dialysis 6

What are the risk factors for developing diabetic nephropathy?

  • Smoking
  • Uncontrolled blood glucose levels/consistently high levels
  • Family history of kidney disease
  • Being Mexican, African American, or Native American
  • Having other complications from diabetes (retinopathy, neuropathy)
  • Being overweight or obese
  • Being diagnosed with diabetes prior to age 20

How is nephropathy prevented?

The most important thing you can do for yourself to help prevent nephropathy is to gain control of your blood glucose levels and your blood pressure. Maintaining a healthy diet, exercising, and practicing weight management are important parts of this, as is taking any medications as directed by your health care team. Maintaining consistent appointments with your doctors is also vital to catching kidney damage early on.

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How is diabetic nephropathy treated?

One of the first things your health care team will advise is gaining control of your blood pressure and blood glucose levels to prevent the damage from progressing. This may include:

  • Losing weight
  • Quitting smoking
  • Starting an exercise program
  • Decreasing or eliminating alcohol consumption
  • Decreasing salt consumption
  • Modifying your diet (i.e. low protein to lessen the work required of kidneys)

Medications might also be included in your treatment plan. Blood pressure drugs can be a complicated prescription for people with diabetes. It’s important that you and your doctor establish a treatment plan that works cohesively with both conditions. It is likely that they will prescribe ACE inhibitors, which can lower blood pressure and, according to recent studies, lower the progression of kidney disease.

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