The term diabetic nephropathy is used to indicate damage to the kidneys caused by diabetes. It is a common complication of diabetes, which can cause significant health problems and even death in diabetics. A person with diabetes is considered to have diabetic nephropathy when more than 300 mg of protein is present in the urine per 24 hours. The characteristic features of diabetic nephropathy are:
- Persistent albuminuria (>300 mg/d or >200 μg/min) documented at least 2 times in 3-6 months apart.
- Progressive decline in the kidney function (glomerular filtration rate or GFR).
- Increase in blood pressure.
Research has shown that the kidney damage caused by diabetes starts a few years after the onset of the disease and progresses slowly. It usually does not cause any symptom in the initial stages of the kidney damage. Symptoms surface 5 to 10 years after the kidney damage starts. Kidney damage or disease is usually progressive. It is, however, important to remember that everyone who has diabetes does not develop diabetic nephropathy and diabetic nephropathy does not progress to renal failure in all the cases.
Most cases of diabetic nephropathy can be prevented or the progress of the disease can be slowed with appropriate care. Serious kidney problems in diabetes can be prevented by:
- Maintaining blood sugar as normal as possible. This requires regular follow up with your doctor, taking medications as recommended and getting blood sugar levels as recommended by your doctor.
- Maintaining a healthy body weight or BMI (BMI: body mass index of 18.5–24.9 kg/m2 is considered healthy).
- Eating a healthy and balanced diet. Your diet should include food with low glycemic index such as whole grain food products, fruits and vegetables. Avoid processed food, fatty food and food with simple carbohydrates. Your doctor will advise you more the food that should be taken or avoided.
- Being physically active and doing exercises regularly.
- Avoiding smoking and alcohol.
- Regular screening for kidney damage by your doctor. Urine tests to detect a protein called albumin (test for microalbuminuria) in diabetics should be done at least once every year.
- Regular evaluation of blood pressure. The risk of diabetic nephropathy and progress of kidney damage is higher in people with high blood pressure.
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