Diabetic nephropathy; Nephropathy - diabetic; Diabetic glomerulosclerosis; Kimmelstiel-Wilson disease
Kidney disease or kidney damage often occurs over time in people with diabetes. This type of kidney disease is called diabetic nephropathy.
Each kidney is made of hundreds of thousands of small units called nephrons. These structures filter your blood, help remove waste from the body, and control fluid balance.
In people with diabetes, the nephrons slowly thicken and become scarred over time. The nephrons begin to leak, and protein (albumin) passes into the urine. This damage can happen years before any symptoms of kidney disease begin.
Kidney damage is more likely if you:
Often, there are no symptoms as the kidney damage starts and slowly gets worse. Kidney damage can begin 5 to 10 years before symptoms start.
People who have more severe and long-term (chronic) kidney disease may have symptoms such as:
Your health care provider will order tests to detect signs of kidney problems.
A urine test looks for a protein, called albumin, leaking into the urine.
Your provider will also check your blood pressure. High blood pressure damages your kidneys, and blood pressure is harder to control when you have kidney damage.
A kidney biopsy may be ordered to confirm the diagnosis or look for other causes of kidney damage.
If you have diabetes, your provider will also check your kidneys by using the following blood tests every year:
When kidney damage is caught in its early stages, it can be slowed with treatment. Once larger amounts of protein appear in the urine, kidney damage will slowly get worse.
Follow your provider's advice to keep your condition from getting worse.
Keeping your blood pressure under control (below 140/90 mm Hg) is one of the best ways to slow kidney damage.
CONTROL YOUR BLOOD SUGAR LEVEL
You can also slow kidney damage by controlling your blood sugar level through:
OTHER WAYS TO PROTECT YOUR KIDNEYS
Many resources can help you understand more about diabetes. You can also learn ways to manage your kidney disease.
Call your provider if you have diabetes and you have not had a urine test to check for protein.
American Diabetes Association. 11. Microvascular Complications and Foot Care: Standards of Medical Care in Diabetes-2021. Diabetes Care. 2021 Jan;44(Suppl 1):S151-S167. PMID: 33298422 pubmed.ncbi.nlm.nih.gov/33298422/.
Brownlee M, Aiello LP, Sun JK, et al. Complications of diabetes mellitus. In: Melmed S, Auchus, RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. Williams Textbook of Endocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020:chap 37.
Tong LL, Adler S, Wanner C. Prevention and treatment of diabetic kidney disease. In: Feehally J, Floege J, Tonelli M, Johnson RJ, eds. Comprehensive Clinical Nephrology. 6th ed. Philadelphia, PA: Elsevier; 2019:chap 31.BACK TO TOP
Review Date: 1/26/2020
Reviewed By: Brent Wisse, MD, board certified in Metabolism/Endocrinology, Seattle, WA. Internal review and update on 06/03/2021 by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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