kidney disease or damage. Diabetic nephropathy is damage to your kidneys caused
diabetes. 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
For reasons doctors don't yet understand, only
some people who have diabetes get kidney damage.
Certain things make you more likely to get diabetic nephropathy. If you
high blood pressure or high cholesterol, or if you smoke, your risk is
higher. Also, Native Americans, African Americans, and Hispanics (especially
Mexican Americans) have a higher risk.
There are no symptoms in
the early stages. So it's important to have regular urine tests to find kidney
damage early. Sometimes early kidney damage can be reversed.
As your kidneys are less
able to do their job, you may notice swelling in your body, most often in your
feet and legs.
is diagnosed using simple tests that check for a protein called
albumin in the urine. Urine doesn't usually contain
protein. But in the early stages of kidney damage—before you have any
symptoms—some protein may be found in your urine, because your kidneys aren't
able to filter it out the way they should.
Finding kidney damage
early can keep it from getting worse. So it's important for people with
diabetes to have regular testing, usually every year.
The main treatment is medicine
to lower your blood pressure and prevent or slow the damage to your kidneys.
These medicines include:
- Angiotensin-converting enzyme inhibitors,
also called ACE inhibitors.
- Angiotensin II receptor blockers, also
As damage to the kidneys gets worse,
your blood pressure rises. Your
triglyceride levels rise too. You may need to take more than one medicine to treat these complications.
And there are other steps
you can take. For example:
- Keep your blood sugar levels within your target range. This can help slow the damage to the small blood vessels in the kidneys.
- Work with your doctor to keep your blood
pressure under control. For most people who have diabetes, the ideal blood pressure is below 120/80. High blood pressure is 140/80 or higher when you have diabetes.
- Keep your heart healthy by eating healthy foods and exercising regularly. Preventing heart disease is important, because
people with diabetes are more likely to have heart and blood
vessel diseases. And people with kidney disease are at an even higher risk for
- Watch how much protein you eat. Eating too much is
hard on your kidneys. If diabetes has affected your kidneys, limiting how much
protein you eat may help you preserve kidney function. Talk to your doctor or
dietitian about how much protein is best for you.
- Watch how much salt you eat. Eating less salt helps keep high
blood pressure from getting worse.
- Don't smoke or use other