Uncontrolled diabetes is known to damage the vital organs of the body such as the heart, liver, and kidneys. Diabetic nephropathy is one such serious complication of type 1 and type 2 diabetes that affects kidney function, resulting in excess fluid buildup in the body. The prevalence of diabetic nephropathy in India is around 34.4%. However, early diagnosis, treatment, and lifestyle changes can prevent the development of diabetic nephropathy and prevent its progression to end-stage kidney disease.

Symptoms Of Diabetic Nephropathy

Diabetic nephropathy may not cause any signs or symptoms in its early stages. However, as the condition progresses, a few symptoms that you may notice include:

• Swelling of hands, legs, feet or eyes
• Frequent urge to urinate
• Irregular blood pressure
• Fatigue
• Nausea and vomiting
• Loss of appetite
• Shortness of breath
• Presence of protein in the urine
• Persistent itching

Causes Of Diabetic Nephropathy

The kidneys are made of millions of tiny blood vessel clusters that filter wastes from your blood. These blood vessels tend to get damaged due to diabetes and hypertension (high blood pressure), resulting in reduced kidney function. Over time, poorly controlled diabetes and hypertension ultimately lead to kidney failure.

Risk Factors For Diabetic Nephropathy

If you have diabetes, the following factors can increase your risk for diabetic nephropathy:

• Uncontrolled blood sugar levels
• Uncontrolled blood pressure (hypertension)
• Smoking
• Obesity
• High blood cholesterol
• Family history of diabetes and kidney disease

Prevention Of Diabetic Nephropathy

If you have type 1 or type 2 diabetes, you can take proactive measures to delay the onset and progression of diabetic nephropathy. These include:

• Taking your medications regularly
• Maintaining a healthy Body Mass Index (BMI) by exercising
• Eating a balanced diet
• Routinely visiting your doctor for follow-up

Early diagnosis is key to controlling the progression of the disease. Annual screening for microalbuminuria may be recommended by your doctor. You can also talk to your doctor to know the tests that you must undergo to reduce your risk.

Treatment Of Diabetic Nephropathy

Treatment for diabetic nephropathy usually focuses on reducing the signs and preventing progression. The treatment includes:

• Medications to control blood pressure, blood sugar, and cholesterol levels.
• Medications to lower kidney inflammation and scarring.

In advanced cases of diabetic nephropathy, dialysis (a process to remove waste from the blood using mechanical support) or organ transplant may be recommended.

FAQs

1. What are the stages of diabetic nephropathy?

There are five stages of diabetic nephropathy:

Stage 1: Kidney damage is present, but there is normal kidney function with a glomerular filtration rate (GFR) of 90% or above. GFR depicts how well your kidneys are working.

Stage 2: Kidney damage with some loss of function and a GFR of 60% to 90%

Stage 3: Mild to severe loss of kidney function and a GFR of 30% to 59%

Stage 4: Severe loss of kidney function and a GFR of 15% to 29%

Stage 5: Kidney failure and a GFR under 15%

2. Can diabetic nephropathy be cured?

Diabetic nephropathy cannot be cured completely. However, its progression can be controlled significantly by effective monitoring and controlling of blood sugar and blood pressure levels.

3. How long does it take for diabetic nephropathy to develop?

Diabetic nephropathy usually develops gradually. Therefore, a diabetic can modify their lifestyle and lower their risk before the condition develops.

4. How is diabetic nephropathy diagnosed?

If you have diabetes and/or hypertension, your doctor would recommend blood tests, x-rays and ultrasounds to assess your kidney structure, size, and functioning. You may also need a CT scan or MRI to identify blood circulation in your kidneys and determine if your condition has progressed to diabetic nephropathy.

If you need expert guidance,

Consult An Apollo Nephrologist

You can also try the Apollo 24|7 Diabetes Self-Management Tool to log your sugar values, track patterns, know all about food nutrition and more.

Medically reviewed by Dr Sonia Bhatt.