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What Is Diabetic Nephropathy?
Diabetic nephropathy — also known as diabetic kidney disease — is a chronic kidney disease. Diabetic kidney disease occurs when your kidneys are damaged because of high blood sugar levels caused by diabetes. When your kidneys are damaged, they may not work correctly.
What are the stages of diabetic nephropathy?
There are five stages of diabetic nephropathy based on how well your kidneys are working. Your doctor will use the results of a blood test called the glomerular filtration rate (GFR) to determine the stage of your kidney disease.
Stages of diabetic nephropathy include:
- Stage 1 — Kidneys function normally.
- Stage 2 — Mild loss of kidney function.
- Stage 3a — Mild to moderate loss of kidney function.
- Stage 3b — Moderate to severe loss of kidney function.
- Stage 4 — Severe loss of kidney function.
- Stage 5 — End-stage kidney disease.
What causes diabetic nephropathy?
Diabetic nephropathy is caused by high blood sugar levels that damage the blood vessels in your kidneys. This blood vessel damage may cause your kidneys to stop filtering your blood as they should, leading to a buildup of fluids and waste in your body.
What are diabetic nephropathy risk factors and complications?
Diabetic nephropathy risk factors
If you have type 1 or type 2 diabetes, you are at risk of developing diabetic nephropathy.
Other risk factors that make diabetic nephropathy more likely include:
Complications of diabetic nephropathy
If left untreated, diabetic nephropathy can cause kidney failure, which is life-threatening.
How can I reduce my risks for diabetic nephropathy?
The best way to reduce your risk for diabetic nephropathy is to take care of your health. Maintain a healthy weight and manage your blood sugar and blood pressure levels.
To further reduce your risk of diabetic nephropathy, you can:
- Control chronic conditions — See a doctor for regular care if you have diabetes or high blood pressure. You may need routine tests to check your kidney function.
- Eat healthy — Eat a healthy diet with lots of fruits and vegetables. They're high in potassium, which promotes healthy blood pressure. Limiting salt from shakers and processed foods also helps reduce blood pressure.
- Exercise — Aim for at least 30 minutes of moderate-intensity physical activity most days of the week.
- Get preventive care — Routinely check your blood pressure and blood sugar (glucose).
- Keep track of medications — Inform your doctor if you routinely take over-the-counter drugs or herbal supplements and avoid or limit the use of NSAID medications (e.g., ibuprofen, naproxen).
- Manage stress — Take steps to manage stress and get at least 7 to 8 hours of sleep each night.
- Reduce alcohol intake — Limit alcohol to one drink a day for women and two drinks per day for men.
- Stop smoking — Quit smoking if you smoke cigarettes or marijuana.
How common is diabetic nephropathy?
According to the National Institutes of Health, diabetes is the leading cause of kidney disease. About one in three adults with diabetes will develop diabetic nephropathy.
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What Are the Signs and Symptoms of Diabetic Nephropathy?
Diabetic nephropathy doesn’t usually cause symptoms in its early stages. As the condition progresses, you may experience symptoms including:
- Bubbly or foamy pee.
- Confusion or trouble focusing.
- Dry, itchy skin.
- Fatigue.
- Muscle pain or cramps.
- Nausea and vomiting.
- Poor appetite.
- Shortness of breath.
- Swelling in your face, hands, and feet.
When should I see a doctor about my diabetic nephropathy symptoms?
If you are experiencing symptoms of diabetic nephropathy, you should schedule an appointment with your doctor as soon as possible. Early treatment can help prevent further kidney damage and reduce your risk of complications.
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How Do You Diagnose Diabetic Nephropathy?
Your doctor will perform a physical exam, talk to you about your health history, and order blood and urine tests to diagnose diabetic nephropathy.
What to expect during your visit
During your visit, your doctor will:
- Ask about any medications you’re taking.
- Perform a physical exam.
- Order blood or urine tests.
- Review your health history.
Tests to diagnose diabetic nephropathy
Your doctor may order blood or urine tests to diagnose CKD. Blood tests include:
- Blood urea nitrogen (BUN) — Shows how well your kidneys are filtering urea nitrogen, a waste product, from your blood.
- Electrolyte and other tests — Checks for imbalances in electrolyte and mineral levels in your body, such as sodium, potassium, and bicarbonate.
- Estimated glomerular filtration rate (eGFR) — This shows how efficiently your kidneys function based on age, creatinine level, and sex.
- Serum (blood) creatinine — Shows how well your kidneys are filtering creatinine, a waste product, from your blood.
Urine tests include:
- Urine albumin-to-creatine ratio (uACR) — Looks for high levels of a protein called albumin in your urine.
- Urine protein-to-creatinine ratio (uPCR) — Looks for high levels of all types of protein in your urine, not just albumin.
Other less common tests include:
- CT scan — A test that creates images of the organs, bones, and tissues in your body.
- Kidney biopsy — A procedure that involves taking small pieces of kidney tissue for examination under a microscope to check for signs of disease.
- Ultrasound — Uses sound waves to create images of your organs to check for problems.
Diabetic nephropathy prognosis
How fast does diabetic nephropathy progress?
For most people with diabetes, diabetic nephropathy takes years to develop and progresses slowly. Although kidney damage isn’t reversible after it happens, you can take steps to prevent or slow the progression of diabetic nephropathy.
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How Do You Treat Diabetic Nephropathy?
Lifestyle changes
Your doctor may recommend making lifestyle changes to help manage your diabetes or high blood pressure, including:
- Eating a healthy diet.
- Exercising.
- Maintaining a healthy weight.
- Quitting smoking.
Medicine to treat diabetic nephropathy
Your doctor may prescribe medications to help reduce your risk of diabetic nephropathy, including:
- Blood pressure medications, including ACE inhibitors and angiotensin II receptor blockers.
- Diabetes medications, including oral and injectable drugs.
- Cholesterol medications, such as statins.
Your doctor may also recommend that you avoid taking NSAIDs or other medications that can damage your kidneys.
Treatment for advanced diabetic nephropathy
If your diabetic nephropathy causes end-stage kidney disease (kidney failure), you may need advanced, life-saving treatment, including:
- Dialysis — You may need dialysis, also called renal replacement therapy, which uses a special machine to filter and clean your blood.
- Kidney transplant — If you have end-stage renal disease, a kidney transplant may be the key to getting you back to your healthy life. We partner with UPMC kidney transplant experts to provide care before, during, and after transplant.
Why choose UPMC for diabetic nephropathy care?
When you choose UPMC for diabetic nephropathy care, you will receive:
- Access to world-class nephrology expertise — Our world-renowned experts treat the full spectrum of kidney diseases using the latest diagnostic and treatment techniques.
- A full range of treatment options — We'll work with you to develop a treatment plan that slows the progression of your disease as much as possible and improves your quality of life.
- Multidisciplinary care — We partner with special dialysis clinics, experts in supportive care, and kidney transplant surgeons to ensure you receive complete care.
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By UPMC Editorial Staff. Last reviewed on 2025-04-24.
