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Diabetic kidney disease is damage to your kidneys caused by diabetes. This is sometimes called diabetic nephropathy. In severe cases it can lead to kidney failure. But not everyone with diabetes has kidney damage.
The kidneys have many tiny blood vessels that filter waste from your blood. High blood sugar from diabetes can destroy these blood vessels. Over time, the kidney isn't able to do its job as well. Later it may stop working completely. This is called kidney failure.
There are no symptoms in the early stages. So it's important to have regular urine tests to find kidney damage early. As your kidneys are less able to do their job, you may have swelling in your body, often in your feet and legs. Other symptoms may include poor appetite, weight loss, and weakness.
Diabetic kidney disease is diagnosed using tests that check how well your kidneys are working. These include a test that checks for a protein called albumin in the urine. Another test checks how well your kidneys are filtering waste from your blood. This is called the estimated glomerular filtration rate (eGFR).
The main treatment for diabetic kidney disease is medicine to lower your blood pressure and prevent or slow kidney damage. Lifestyle changes can help. Keeping your blood sugar levels within your target range can also help slow kidney damage.
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To help prevent kidney damage, keep your blood sugar in your target range and control your blood pressure. Do this by eating healthy foods, staying at a healthy weight, exercising regularly, and taking medicines as directed. If there's protein in your urine, high blood pressure medicines can help keep kidney damage from getting worse.
There are no symptoms in the early stages of diabetic kidney disease. If you have kidney damage, you may have small amounts of protein leaking into your urine. (This is called albuminuria.)
As diabetic kidney disease progresses, your kidneys can't do their job as they should. They can't clear toxins or balance the chemicals in your blood very well. You may:
You may have symptoms if your kidney disease gets worse. They include:
If the kidneys are severely damaged, blood sugar levels may drop. That's because the kidneys can't remove excess insulin or filter medicines that increase insulin production.
Diabetic kidney disease is diagnosed using tests that check how well your kidneys are working. These include a test that checks for a protein (albumin) in the urine. Another test checks how well your kidneys are filtering waste from your blood. This is called the estimated glomerular filtration rate (eGFR).
An albumin urine test can detect very small amounts of protein in the urine. This allows doctors to find kidney disease early. Starting treatment early can prevent further damage to the kidneys.
The eGFR is measured using a formula that compares a person's size, age, sex, and race to blood creatinine levels. As kidney disease gets worse, the eGFR number goes down.
When your doctor will start checking your kidney function depends on the type of diabetes you have. After testing starts, it should be done every year.footnote 1
The main treatment is medicine to lower your blood pressure and prevent or slow the damage to your kidneys. Medicines include:
There are other steps you can take. For example:
As kidney damage gets worse, your blood pressure and cholesterol level rise. You may need to take more than one medicine to treat these problems. If damage becomes severe, you may need kidney dialysis or a transplant.
CitationsAmerican Diabetes Association (2021). Standards of medical care in diabetes—2021. Diabetes Care, 44(Suppl 1): S1–S232. Accessed January 5, 2021.
Current as of: December 2, 2020
Author: Healthwise StaffMedical Review: E. Gregory Thompson MD - Internal MedicineKathleen Romito MD - Family MedicineAdam Husney MD - Family MedicineTushar J. Vachharajani MD, FASN, FACP - Nephrology
Current as of: December 2, 2020
Author: Healthwise Staff
Medical Review:E. Gregory Thompson MD - Internal Medicine & Kathleen Romito MD - Family Medicine & Adam Husney MD - Family Medicine & Tushar J. Vachharajani MD, FASN, FACP - Nephrology
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