What is Diabetic Nephropathy?

By  , Expert Content
Dec 22, 2011

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Diabetic nephropathy is a kidney disease or damage which occurs due to diabetes. Currently, it is a major cause of chronic renal failure in adults, sickness and death in people with diabetes.

Kidney is a bean shaped organ situated in the rear of the abdomen. Most people have one kidney on each side of the spine. Each kidney has thousands of small units called nephrons. The nephrons are the functioning unit of kidney, which filter the blood and help to remove waste from your body.

Diabetic nephropathy is a major complication of diabetes. Diabetes affects the nephrons and slowly thickens and becomes scarred over time. Damage to the nephrons impairs the function of kidney and protein (albumin) passes into the urine.

The exact cause of damage to kidneys in diabetes is not known. Experts believe that poor control of blood sugar causes kidney damage. Studies have shown that diabetic nephropathy occurs more commonly in people with poor control of blood sugar and progresses rapidly if the blood sugar is not maintained well. Other factors that increase the risk of kidney damage in diabetes are:

  • High blood pressure (risk increase progressively with increase in blood pressure).
  • Family history of kidney disease.
  • Smoking.
  • Age at diagnosis (risk is higher in people who developed type 1 diabetes before age 20).
  • Race (more common in people of African-American, Hispanic and American Indian origin).

The kidney damage in diabetes progresses slowly. In the initial stages, most people do not have any symptoms. Most people develop symptoms 5 to 10 years after the kidney damage commences. Many cases are diagnosed when the kidney damage is severe. Some symptoms that may occur in people with severe kidney disease include poor appetite, fatigue, general ill feeling, headache, swelling of the legs, nausea and vomiting. If you have symptoms suggestive of kidney Disease, your doctor will recommend blood and urine tests.

If you are a diabetic, your doctor may recommend tests to find signs of kidney problem/s in the early stages. Experts recommend urine tests once a year to detect the presence of a protein called albumin in people with diabetes. Presence of excessive protein in the urine (more than normal amount) is often a sign of kidney damage. In healthy people, very minimal amount of albumin is excreted in the urine (less than 150 mg in a 24-hour collection). In people with diabetes, the urine is tested for the presence of albumin i.e. microalbuminuria or macroalbuminuria (urinary albumin excretion of more than 300 mg in a 24-hour collection). When the test looks for small amounts of albumin in urine, it is called a test for microalbuminuria (urinary albumin excretion of 150-300 mg in a 24-hour collection).

In addition to urinary protein, kidney function is also checked with the following blood tests every year:

  • BUN (blood urea nitrogen).
  • Serum Creatinine.

Early detection, strict blood glucose control and control of blood pressure can decrease the risk of kidney damage in diabetes.


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