Did you know that diabetes is the foremost cause of kidney disease? If you have Type 2 Diabetes, you are at an increased risk of developing diabetic nephropathy. This article will discuss what causes diabetic nephropathy, how it is diagnosed and treated, and how to protect your kidneys from diabetes-related complications.
Diabetic nephropathy or diabetic kidney disease is a common long-term complication of both Type 1 and Type 2 Diabetes.
When your blood sugar levels are high for a long time, they can damage the inner lining of the walls of the blood vessels of your kidneys. Due to this, cholesterol and debris can accumulate in the damaged walls leading to blockage and narrowing of the blood vessels. Hence, your kidneys are unable to effectively filter out waste materials from your body, causing the excretion of important nutrients (proteins) and accumulation of fluid, leading to the development of diabetic nephropathy.
The following are the signs and symptoms of diabetic kidney disease:
Consult your doctor if you have diabetes and are experiencing any of these symptoms.
The progression of diabetic nephropathy can be divided into 5 stages based on the glomerular filtration rate (a test used to check how well your kidneys are functioning) of your kidneys.
The glomerular apparatus is a structure in your kidney made up of small blood vessels that functions as the filtration unit. Their capacity to filter your blood is measured in mL/min/1.73 m² (mL of blood filtered per minute relative to body surface area).
As diabetic kidney disease progresses, the glomeruli become less efficient in filtering waste and their capacity decreases.
| Stage of Nephropathy | GFR | Other Characteristics |
| Stage 1 or Hyperfiltration | >90 mL/min/1.73 m² Normal | Increased renal size and function |
| Stage 2 or Silent nephropathy | >90 mL/min/1.73 m² Normal | Mild thickening of renal membranes and tissues |
| Stage 3 or Incipient nephropathy | <60 mL/min/1.73 m² | Mild to moderate thickening, increased levels of proteins in urine, first clinical signs of kidney damage |
| Stage 4 or Overt nephropathy | <30 mL/min/1.73 m² | Severe thickening and scarring, increased excretion of proteins in urine, significant loss of kidney function |
| Stage 5 or End Stage Renal Disease (ESRD) or kidney failure | <15 mL/min/1.73 m² | Major loss of kidney function, need for dialysis or kidney transplant |
The following factors can increase your risk of developing diabetic nephropathy:
Diabetic kidney disease can be diagnosed through blood and urine tests like:
Creatinine is a waste product (formed by the normal breakdown of muscle cells) that is filtered out of your blood by healthy kidneys. High blood creatinine levels indicate that your kidney is unable to function properly.
Albumin, a protein made by your liver, is usually not found in urine. If your urine albumin levels are high, it signals kidney damage.
This test helps to measure the capacity of your kidney to filter out waste from your body. Healthy kidneys have a GFR of >90 mL/min/1.73 m².
Sometimes, X-rays, CT scans or MRIs can be used to diagnose kidney disease to identify the extent of kidney damage.
Potential complications of Diabetic Nephropathy include:
Treatment for diabetic kidney disease is based on controlling the factors that cause kidney damage and reducing the load on your kidneys.
In the initial stages of diabetic nephropathy, the treatment strategy is focused on lowering blood sugar, cholesterol, and blood pressure. Some medicines may be prescribed to prevent kidney inflammation and scarring.
In the later stages of nephropathy, dialysis may be required to eliminate waste from your body due to reduced kidney function.
In cases where the function of both kidneys is severely affected, doctors may recommend a kidney transplant.
If you have diabetes, following these precautions can lower your risk of developing nephropathy:
Consult your doctor immediately if you are experiencing muscle cramps, unexplained fatigue, rashes, nausea for more than a week or if you see blood in your urine.
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