Diabetic Nephropathy

Contact the UPMC Kidney Disease Center

To make an appointment with one of our kidney disease experts, call 412-802-3043 or book an appointment online.

Overview
Symptoms and Diagnosis
Treatment

What Is Diabetic Nephropathy?

Diabetic nephropathy is kidney disease that develops due to diabetes.

In people with diabetes, too much blood sugar or glucose can damage blood vessels inside the kidneys and affect how they work. Both type 1 and type 2 diabetes can cause kidney disease.

About 1 in 3 adults with diabetes may have chronic kidney disease.

Types of diabetic nephropathy

Doctors also call diabetic nephropathy diabetic kidney disease or chronic kidney disease (CKD) due to diabetes.

Diabetes can cause damage to the glomerulus, the part of the kidney that filters blood. There are many of them in your kidneys. When these filters get damaged, this is diabetic glomerulopathy.

Diabetic kidney disease causes

Excessive blood sugar levels from diabetes damage blood vessels inside the kidneys. This damage happens over time, so you might not notice any symptoms of kidney disease at first.

High blood pressure in people with diabetes can also cause the disease.

Blood vessels in the kidneys become damaged, making it hard for kidney filters to remove waste. When this occurs, fluid starts to build up in the body.

Diabetic kidney disease risk factors and complications

Having diabetes puts you at risk for diabetic kidney disease.

You're also at greater risk if you:

Have blood glucose levels that are too high. Your doctor will talk with you about the sugar level that's right for you.
Have high blood pressure, and you don't take medicine to get it under control.
Are overweight.
Smoke.

When you can't manage blood sugar levels and blood pressure, diabetic kidney disease can progress to kidney failure or end-stage renal disease.

If you have kidney failure, your kidneys can no longer filter your blood. This leads to a build-up of waste and fluid in the body.

Doctors treat end-stage kidney disease with dialysis to filter waste and fluid or a kidney transplant.

How to prevent diabetic kidney disease

Preventing diabetic kidney disease starts with knowing your risk factors. It's also important to know that you might not have any symptoms until the disease has progressed.

Steps you can take to help prevent or reduce your risk of kidney disease include:

See your doctor routinely and get tested for kidney disease.
Check your blood sugar often to make sure your levels are in the right range.
Control high blood pressure if you have it.
Lose weight if you need to.
Make healthy lifestyle changes. These include getting regular exercise, eating healthy foods, and not smoking.

If you have kidney disease, these steps can also help keep it from getting worse.

Why Choose UPMC For Diabetic Nephropathy Care?

The UPMC Kidney Disease Center includes leading experts in the field of kidney disease. We work with your PCP and endocrinologists on a treatment plan to slow the progression of your diabetic kidney disease.

We also partner with UPMC's kidney transplant experts, offering care for diabetic kidney disease that has progressed to end-stage renal disease.

Learn More About Diabetic Kidney Disease

Diabetic Nephropathy Symptoms and Diagnosis

If you have diabetic nephropathy — or diabetic kidney disease — you might not know you have it. Sometimes, symptoms don't start until kidney disease has progressed.

Let your doctor know if:

Your feet or legs look puffy.
Your urine looks foamy.
You don't feel like eating.
You have an upset stomach or feel nauseous.
You feel extremely tired or fatigued.

These might be signs that fluid and waste are building up in your body.

Diagnosing diabetic kidney disease

To find out if your kidneys are working properly, your doctor might order:

A urine test for albumin, a protein. When doctors see small amounts of this protein in the urine, it's a sign that kidney damage exists.
A blood test for glomerular filtration rate, or GFR. This is a measure of the kidney's filtering function.
Tests to measure creatinine levels in blood and urine. These tests show how well the kidneys are getting rid of waste.
An ultrasound — a non-invasive scan where doctors look at images to help them diagnose kidney disease.
Blood pressure tests to measure blood pressure levels and changes.
Kidney biopsy, a test in which doctors look at a small piece of kidney tissue for signs of disease.

Your doctor might want you to have other tests based on your specific condition.

Diabetic Nephropathy Treatment

The experts at UPMC's Kidney Disease Center work with you on a treatment plan to best manage your diabetic kidney disease.

Our treatment goals are to either reverse your kidney disease when possible or slow its progress.

Lifestyle changes to manage diabetic kidney disease

Doctors often suggest lifestyle changes to treat your kidney disease.

Some of these changes include:

Keeping blood glucose levels within a healthy range.
Controlling high blood pressure.
Eating a healthy diet.
Exercising.
Not smoking.

Medicine to treat diabetic kidney disease

Doctors sometimes prescribe certain drugs to help prevent or slow the progression of diabetic kidney disease.

These include drugs to:

Lower blood pressure.
Reduce albumin in urine with certain blood pressure and diabetes medications, such as ace-inhibitors or SGLT-2 inhibitors.
Control blood sugar, such as insulin for people with type 1 diabetes. People with type 2 diabetes might take an SGLT-2 inhibitor.

Kidney transplant surgery

When diabetic nephropathy progresses to end-stage renal disease, or kidney failure, your doctor might refer you to the UPMC kidney transplant program.

During a transplant, you'll receive a healthy kidney from a donor. The donor might be living or deceased.

After kidney transplant, you'll have to make certain changes to protect your new kidney and its function.

You'll need to limit salt in your diet to help manage your blood pressure. And you'll also need to take anti-rejection drugs to prevent your body from trying to destroy the new kidney.