FamilyDoctor.org -- health information for the whole family

Diabetic Nephropathy

What is diabetes?

Your body changes most of the food you eat into glucose (a form of sugar). Insulin is a hormone produced by the pancreas that allows glucose to enter all the cells of your body and be used as energy.

Diabetes is a disease that occurs when a person’s body doesn’t make enough insulin or can’t use insulin properly. When you have diabetes, the sugar builds up in your blood instead of moving into the cells. Too much sugar in the blood can lead to serious health problems, including heart disease and damage to the nerves and kidneys.

There are 2 types of diabetes. Type 1 diabetes occurs when the body doesn’t produce any insulin. In type 2 diabetes, the body either doesn’t produce enough insulin or the cells ignore the insulin. Nearly 95% of people who are diagnosed with diabetes have type 2 diabetes.

Return to top

What is diabetic nephropathy?

Diabetes can affect many parts of the body, including the kidneys. In healthy kidneys, many tiny blood vessels filter waste products from your body. The blood vessels have holes that are big enough to allow tiny waste products to pass through into the urine, but still small enough to keep useful products (such as protein and red blood cells) in the blood. These vessels can be damaged by high levels of sugar in the blood if diabetes is not controlled. This can cause kidney disease, which is also called nephropathy (say: nef-rah-puh-thee). If the damage is bad enough, your kidneys could stop working.

Return to top

What are the 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 concentrating

Return to top

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.

Return to top

What can I do to slow down the damage?

The following are some of the most important things you can do to protect your kidneys:
  • Keep your blood pressure lower than 130 over 80. High blood pressure can speed up damage to the kidneys. Your doctor may give you medicine to help lower your blood pressure.
  • Control your blood sugar level. You should 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 active every day.
  • Stop smoking.
  • Check with your doctor before taking any new medicines. This includes vitamins, herbal medicines and over-the-counter medicines.
  • Keep all of your doctor appointments.

Return to top

What happens if my kidneys stop working?

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 (say: die-al-uh-sis). In dialysis, a machine is used to take waste products out of the blood. One kind of dialysis has to be done in a clinic. For another kind of dialysis, the machine is so small it can be strapped 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.

Return to top

Other Organizations

Return to top

Source

Written by familydoctor.org editorial staff.

Diabetic Nephropathy: Common Questions by Micah L. Thorp, D.O., M.P.H., (American Family Physician July 1, 2005, http://www.aafp.org/afp/20050701/96.html)

Reviewed/Updated: 06/09
Created: 07/05