What is diabetic nephropathy?

Having diabetic kidney disease (diabetic nephropathy) means that for some time you have had high blood sugar, which damages the kidneys. This may have taken you by surprise. Damage to kidneys usually doesn't cause symptoms early on.

Kidneys keep protein in your blood. They also help filter waste from your blood. If your kidneys are damaged by high blood sugar, protein can pass into your urine. And your kidneys can't filter waste as they should. Sometimes this condition can lead to kidney failure.

Your doctor will tell you how you might be able to slow damage to your kidneys. In many cases, prompt and regular treatment can prevent kidney failure. You will need to take medicine. You may need to make changes in your normal routines. To help reduce your chance of kidney failure, keep your blood sugar and blood pressure in your target range. And be sure to take your medicines as prescribed.

There are no symptoms in the early stages. So it's important to have regular urine tests to find kidney damage early. As your kidneys are less able to do their job, you may have swelling in your body, often in your feet and legs. Other symptoms may include poor appetite, weight loss, and weakness.

The main treatment for diabetic kidney disease is medicine to lower your blood pressure and prevent or slow kidney damage. Lifestyle changes can help. Keeping your blood sugar levels within your target range can also help slow kidney damage.

Diabetic kidney disease is diagnosed and watched over time using yearly tests that check how well your kidneys are working. These include a test that checks for a protein (albumin) in the urine. A blood test checks how well your kidneys are filtering waste from your blood. This is called the estimated glomerular filtration rate (eGFR).

An albumin urine test can detect very small amounts of protein in the urine. This allows doctors to find kidney disease early. Starting treatment early can prevent further damage to the kidneys.

The eGFR is measured using a formula that compares a person's size, age, and sex to blood creatinine levels. As kidney disease gets worse, the eGFR number goes down.

When your doctor will start checking your kidney function depends on the type of diabetes you have. After testing starts, it should be done every year.

If your doctor thinks that the protein in your urine or a decreased eGFR may be caused by a disease other than diabetes, other blood and urine tests may be done. Some people may have a small sample of kidney tissue removed and checked. This is called a kidney biopsy.

The kidneys have many tiny blood vessels that filter waste from your blood. High blood sugar from diabetes can destroy these blood vessels. Over time, the kidney isn't able to do its job as well. Later it may stop working completely. This is called kidney failure.

Diabetic kidney disease is damage to your kidneys caused by diabetes. This is sometimes called diabetic nephropathy. In severe cases it can lead to kidney failure. But not everyone with diabetes has kidney damage.