Diabetic kidney nephropathy is a serious complication of diabetes. Learn about nephropathy in diabetes, and how a doctor makes a diabetic nephropathy diagnosis.
Understanding Nephropathy in Diabetes
Healthy kidneys have millions of tiny blood vessels, with even tinier capillary tufts that filter and remove toxic waste products from your blood. If you have diabetes, high blood sugar can put a strain on your kidneys, hindering their ability to do their job.
Nephropathy in diabetes occurs when high blood sugar levels force the kidneys to filter too much blood. This makes the kidney work harder than they were designed to work. After years of being overworked, the filters in the kidneys begin to become leaky, and protein gets into the urine. This may cause two conditions:
- Microalbuminuria: Only a small amount of protein is in the urine.
- Macroalbuminuria: Urine has higher concentrations of protein, due to progressive kidney disease.
Risk Factors for Diabetic Kidney Nephropathy
Having diabetes doesn’t necessarily mean that you’ll develop diabetic nephropathy symptoms. Some risk factors for nephropathy in diabetes are under your control. For example, managing your blood sugar will significantly reduce your risk of developing diabetic nephropathy.
Some other risk factors of diabetic kidney nephropathy include:
- Ethnic heritage (African American, Latino or Native American)
- Family history of high blood pressure or kidney disease
- High blood pressure
- Poor blood sugar control
- Type 1 diabetes onset before age 20.
Diabetic Nephropathy Symptoms
In its early stages, diabetic nephropathy symptoms are non-existent. However, the following symptoms may appear over time:
- Feeling of illness
- Frothing or foamy appearance of urine
- Loss of appetite
- Nausea and vomiting
- Swelling of legs, around the eyes or general body swelling
- Weight gain from fluid build-up.
Diabetic Nephropathy Diagnosis
Early diabetic nephropathy diagnosis is important, as kidney disease can be slowed with treatment. At its earliest stage, damage may actually be reversible.
Since protein may be in the urine five to ten years before any diabetic nephropathy symptoms begin, urine tests (microalbuminuria tests) can be helpful in a diabetic nephropathy diagnosis. Depending on your individual health, your doctor may also perform other diagnostic tests, including:
- 24-hour urine protein
- BUN (measures blood urea nitrogen)
- Blood levels of calcium, bicarbonate, phosphorus, potassium and PTH (parathyroid hormone)
- Protein electrophoresis
- Serum creatinine.
Treating Diabetic Kidney Nephropathy
To protect your kidneys, you’ll want to carefully control your blood sugar and blood pressure. If you are having trouble with this, your doctor may adjust your medication.
Even slight elevations in blood pressure can dramatically speed up the progression of kidney disease. To keep blood pressure levels healthy:
- Avoid alcohol
- Don’t smoke or use tobacco products
- Exercise regularly
- Lower your salt intake
- Reach and maintain a healthy weight.
If these measures aren’t sufficient, your doctor may recommend medication to lower your blood pressure, or a low-protein diet. Never begin this type of diet without consulting a medical professional first.
If nephropathy in diabetes advances to kidney failure, you’ll need either lifetime dialysis or a kidney transplant to survive.
American Diabetes Association. (2010). Kidney disease (nephropathy). Retrieved April 20, 2010, from http://www.diabetes.org/living-with-diabetes/complications/kidney-disease-nephropathy.html.
Medicine Plus. (2009). Diabetic nephropathy. Retrieved April 20, 2010, from http://www.nlm.nih.gov/medlineplus/ency/article/000494.htm.