Diseases & Conditions

 

Diabetic Nephropathy

Diseases & Conditions

 

What is diabetic nephropathy?

Diabetic nephropathy, also known as diabetic kidney disease, is a complication of diabetes caused by damage to the filtering system of the kidneys. Each kidney is made of hundreds of thousands of small units called nephrons that filter the blood, help remove waste from the body, and control fluid balance. Diabetes can damage this system and cause scarring of the nephrons which can lead to diabetic nephropathy.1

 

 What are the risk factors for diabetic nephropathy?

Risk factors that increase the risk of diabetic nephropathy are:2

  • Uncontrolled blood sugar
  • Hypertension
  • Type-1 diabetes that began early in life
  • Family history of diabetes and kidney problems
  • Smoking
  • Ethnicity: Blacks are more prone to develop diabetic nephropathy than Whites.

 

What are the symptoms of diabetic nephropathy?

Symptoms of diabetic nephropathy may develop five to ten years after the damage of the kidney and include:3

  • Weakness
  • Feeling tired
  • Weight loss
  • Loss of appetite
  • Headache
  • Nausea
  • Vomiting
  • Swelling of the arms
  • Swelling of the legs
  • Itchy and dry skin

 

How is diabetic nephropathy diagnosed?

Tests used to diagnose diabetic nephropathy include:4

  • Urinalysis: A urine test will show if a protein (albumin) is present in the urine, which points to kidney damage.
  • An albuminuria dipstick test: This is a simple test that can detect small amounts of protein in the urine.
  • Laboratory test: A spot urine test for albuminuria is a more precise laboratory test that can measure the exact amount of protein in a urine sample.
  • Creatinine test: This test measures the level of creatinine to estimate how efficiently the kidneys are filtering the blood.

 

How is diabetic nephropathy treated?

Treatments of diabetic nephropathy include medications to lower blood pressure and glucose blood levels as well as lifestyle modifications:5

  • Medications to control blood pressure and to treat diabetic nephropathy:
    • Angiotensin-converting enzyme (ACE) inhibitors
    • Angiotensin receptor blockers (ARBs)
  • Medications to treat diabetes
  • Lifestyle changes:
    • Eating healthy foods
    • Getting regular exercise
    • Taking medicine as instructed by the doctor
    • Checking blood sugar level as often as instructed and keeping a record of blood sugar numbers so that the patient knows how meals and activities affect the level

 

How is diabetic nephropathy prevented?

Prevention of diabetic nephropathy is crucial. A patient must follow the following in order to avoid kidney damage:6

  • Tight control of diabetes
  • Blood pressure treatment to systolic pressure of < 130 mmHg
  • Reduction of proteinuria
  • Treatment with drugs that inhibit the renin-angiotensin system

All these steps are associated with prevention of or delay in progression of diabetic kidney injury.

 

References:

  1. Mayo Clinic http://www.mayoclinic.org/diseases-conditions/diabetic-nephropathy/basics/definition/con-20035589 (Accessed February 8, 2016)
  2. S National Library of Medicine https://www.nlm.nih.gov/medlineplus/ency/article/000494.htm (Accessed February 8, 2016)
  3. Healthline http://www.healthline.com/health/type-2-diabetes/nephropathy#Causes2 (Accessed February 8, 2016)
  4. WebMD http://www.webmd.com/diabetes/tc/diabetic-nephropathy-exams-and-tests (Accessed February 8, 2016)
  5. S National Library of Medicine https://www.nlm.nih.gov/medlineplus/ency/article/000494.htm (Accessed February 8, 2016)
  6. Hall, Phillip M. "Prevention of progression in diabetic nephropathy." Diabetes spectrum 19.1 (2006): 18-24.