What is diabetic nephropathy?
Nephropathy refers to kidney disease or injury. Diabetic nephropathy is kidney damage caused by diabetes, which can lead to kidney failure in severe cases. However, kidney injury does not always occur in people with diabetes.
What causes diabetic nephropathy?
The kidneys have many capillaries that filter waste from the blood. Diabetic hyperglycemia may destroy these blood vessels, and the kidneys gradually fail to work properly until they stop working altogether, which is called kidney failure. The risk of developing diabetic nephropathy is higher if you also have high blood pressure or hypercholesterolemia, or if you smoke.
What are the symptoms of diabetic nephropathy?
Diabetic nephropathy is asymptomatic in its early stages. Therefore, it is extremely important to have regular urine tests to detect kidney damage early. Sometimes, early kidney damage can be reversed. As kidney function decreases, patients may notice body swelling, most commonly in the feet and legs.
How is diabetic nephropathy diagnosed?
A simple test can diagnose it: Check the urine for a protein called albumin. Urine usually does not contain protein. However, in the early stages of kidney injury, before symptoms appear, some protein is present in the urine because the kidneys are not able to perform their normal filtration-reabsorption function. Early detection of kidney injury can prevent the condition from getting worse. Therefore, it is important for people with diabetes to have regular (usually annual) checkups.
How to treat diabetic nephropathy?
Diabetic nephropathy is treated mainly with antihypertensive medications and medications that prevent or slow down kidney damage. These medications include:
- Angiotensin-converting enzyme inhibitors, also known as ACEIs.
- Angiotensin II receptor blockers, also known as ARBs.
- Angiotensin II receptor blockers, also known as ARBs.
Blood pressure rises as kidney injury worsens. Cholesterol and triglyceride levels also rise, and multiple medications may be needed to treat these complications. Other approaches may also be used, such as:
- Keeping blood glucose levels in the target range. This helps slow damage to the kidney capillaries.
- Cooperate with your doctor to control blood pressure. Your doctor will give you blood pressure goals based on your patient’s health status and age. For example, keep blood pressure below 140/90 mm Hg.
- Keep your heart healthy by eating a healthy diet and getting regular exercise. Preventing heart disease is important because people with diabetes are more likely to develop cardiovascular disease. People with kidney disease are at higher risk for heart disease.
- Be careful about the amount of protein you consume. Too much can exceed the kidney’s ability to filter. If diabetes impairs kidney function, limiting protein intake can help preserve kidney function. Talk to your doctor or dietitian about the optimal amount of protein to consume.
- Watch the amount of salt you consume. Eating less salt can help prevent worsening of high blood pressure.
- Do not smoke and do not use any tobacco products.
How to prevent diabetic nephropathy?
The best way to prevent kidney injury is to keep your blood sugar in your target range and control your blood pressure. Achieving this goal requires maintaining a healthy diet, a healthy weight, regular exercise, and taking your medications as directed.
The first time protein is found in the urine, take a high blood pressure medication to prevent worsening kidney damage.