Diabetes is the leading cause of kidney disease, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Diabetic kidney disease, also called diabetic nephropathy, is a life-threatening complication of both type 1 and type 2 diabetes. Approximately one in three (1 in 3) diabetic adults develop diabetic nephropathy. Early detection and treatment can significantly slow the progression of the disease, though it cannot be reversed.*

How does diabetes damage the kidneys?

Each of your kidneys contains more than a million waste-filtering units, called nephrons, and each of those nephrons contains millions of tiny blood vessels, called glomeruli. Poorly-controlled diabetes results in high glucose levels in your blood. 

High blood glucose narrows the blood vessels, which causes them to become strained and eventually damaged. Narrowed blood vessels also lead to high blood pressure, which further strains and damages the vessels. High blood pressure is the second leading cause of kidney disease.

What are some other risk factors for diabetic nephropathy?

In addition to having active diabetes, some other risk factors for kidney disease include:

• Inadequately-managed high blood sugar (hyperglycemia) 
• Inadequately-managed high blood pressure (hypertension) 
• High level of low-density lipoprotein (LDLs), i.e., the “bad” cholesterol
• High cholesterol overall
• Being a smoker
• Family history of diabetes or kidney disease

What are some symptoms of diabetic nephropathy?

In the early stages of diabetic kidney disease, you may not notice any signs or symptoms. 

In later stages, the signs and symptoms can include:

• Difficulty controlling blood pressure
• Swelling (edema) of ankles, face, feet, or hands
• Need to urinate frequently
• Protein in the urine
• Reduced need for insulin 
• Difficulty concentrating
• Shortness of breath
• Loss of appetite
• Nausea and vomiting
• Fatigue

What are some possible complications?

Diabetic nephropathy can lead to other health complications, such as:

• Fluid in your lungs (pulmonary edema)
• Too much potassium in your blood (hyperkalemia)
• Cardiovascular disease
• Damaged blood vessels in your retina (diabetic retinopathy)
• Anemia (insufficient red blood cells transporting oxygen)
• Foot sores, erectile dysfunction, diarrhea, and other nerve- and blood-related issues
• Pregnancy hazards concerning both mother and fetus
• Kidney failure, requiring dialysis and/or a kidney transplant

Is there a way to prevent diabetic nephropathy?

While you can’t change genetics, there are several ways to lower your risk of developing diabetic kidney disease, as well as delay or slow down disease progression if you’ve already been diagnosed. 

These prevention methods center on supporting good health through lifestyle choices, such as:

• Treat your existing diabetes.
• Effectively manage high blood pressure and heart disease.
• Consult your doctor before taking over-the-counter (OTC) pain relievers. Use them sparingly, and follow the instructions on the packaging
• Achieve and maintain a healthy weight. Speak with your doctor about a kidney-friendly diet (low sodium, low protein, etc.) and a safe exercise regimen. 
• Don’t start smoking. Quit smoking if you do.

If you experience any of these signs or symptoms, especially if you have a family history of kidney disease, make an appointment to see your doctor. Simple blood and urine tests will show how well your kidneys are working. 

*Mayo Clinic. (2019, Sep. 19). Diabetic Nephropathy. https://www.mayoclinic.org/diseases-conditions/diabetic-nephropathy/symptoms-causes/syc-20354556