Diabetic Nephropathy: Care Instructions

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Your Care Instructions

Finding out that your kidneys have been damaged can be very distressing. It may have taken you by surprise, since damage to kidneys usually does not cause symptoms early on. It is normal to feel upset and afraid.

Having diabetic nephropathy means that for some time you have had high blood sugar, which damages the kidneys. Healthy kidneys keep protein in your blood, where it belongs. Damaged kidneys do not work the way they should. Your kidneys are allowing protein to pass into your urine. Sometimes diabetic kidney disease 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 and may need to make a number of changes in your normal routines. If you can keep your blood sugar and blood pressure under control and take certain medicines, you may reduce your chance of kidney failure.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

  • Take your medicines exactly as prescribed. It is very important that you take your insulin or other diabetes medicine as your doctor tells you. Call your doctor or nurse call line if you think you are having a problem with your medicine.
  • Try to keep blood sugar in your target range.
    • Eat a variety of foods, with carbohydrate spread out in your meals. Your doctor may restrict your protein. A dietitian can help you plan meals.
    • If your doctor recommends it, get more exercise. Walking is a good choice. Bit by bit, increase the amount you walk every day. Try for at least 2½ hours a week.
    • Check your blood sugar as often as your doctor recommends.
  • Take and record your blood pressure at home if your doctor tells you to. Learn the importance of the two measures of blood pressure (such as 130 over 80, or 130/80). To take your blood pressure at home:
    • Ask your doctor to check your blood pressure monitor. He or she can make sure that it is accurate and that the cuff fits you.
    • Do not eat, use tobacco products, or use medicine known to raise blood pressure (such as some nasal decongestant sprays) before taking your blood pressure.
    • Avoid taking your blood pressure if you have just exercised or are nervous or upset. Rest at least 15 minutes before taking a reading.
  • Eat a low-salt diet to keep your blood pressure in your target range.
  • Do not smoke. Smoking raises your risk of many health problems, including diabetic nephropathy. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.
  • Do not take ibuprofen, naproxen, or similar medicines, unless your doctor tells you to. These medicines may make kidney problems worse.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

  • You passed out (lost consciousness).

Call your doctor or nurse call line now or seek immediate medical care if:

  • You have not urinated at all in the last 24 hours.
  • You have trouble urinating or can urinate only very small amounts.
  • You are confused or have trouble thinking clearly.
  • You are very thirsty, light-headed, or dizzy, or you feel like you may pass out (lose consciousness).
  • You have a weak, fast heartbeat.
  • You have swelling in your hands or feet.
  • You have blood in your urine.
  • You are extremely tired or weak.

Watch closely for changes in your health, and be sure to contact your doctor or nurse call line if you have any problems.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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