Also known as kidney disease, diabetic nephropathy is the medical term for damage caused to the kidneys as a result of diabetes. Kidney disease develops slowly over a number of years, however there are steps you can take to prevent it from developing or stop it from getting worse.
What Is Diabetic Nephropathy?
Diabetic kidney disease is a medical diagnosis that’s made when high blood sugar levels have caused damage to the filters and blood vessels in the kidneys. This damage can cause albumin to leak into your urine and cause healthy kidney tissue to be replaced by scar tissue. This scarring can prevent your kidneys from filtering waste and excess fluid from the blood, which can get worse over time.
Kidney disease can be mild or develop into a more serious condition, so it’s really important to understand your risks and make sure you’re attending all your medical appointments, which will help to catch any damage as early as possible.
Symptoms Of Diabetic Nephropathy
In many cases, people with kidney damage from diabetes won’t experience any symptoms until the condition reaches an advanced stage. Some of the most common symptoms include:
- Fatigue
- Swollen hands, feet and ankles
- Itchy skin
- Shortness of breath
- Weight loss
- Muscle cramps
- Needing to urinate more frequently at night
- Feeling sick
These symptoms can develop as the kidneys start to find it difficult to clear waste and extra fluid from the body, however many other health issues can cause similar symptoms so it’s really important to discuss any concerns directly with your healthcare team.
How Kidney Disease Is Detected
There are two different tests that look at the overall health of your kidneys. Most people with diabetes have these tests done once per year and they’re a useful tool for understanding how well your kidneys are working.
ACR Urine Test
The Albumin: Creatinine Ratio or ACR test looks at how much albumin is in your urine and can identify early stage kidney disease. If abnormal amounts are detected, you’ll be offered treatment to prevent the disease from progressing.
eGFR Blood Test
This blood test looks at your creatinine levels alongside a variety of other factors, including your weight, sex and height, in order to understand your glomerular filtration rate. Creatinine is a waste product, so if your levels are higher than they should be, your kidneys may not be functioning as well as they should be.
Medication For Diabetic Kidney Disease
Treatment varies depending on how far your kidney disease has progressed, but there are several medications that may be offered.
Maintaining healthy blood pressure levels can prevent kidney disease from getting worse, so you may be prescribed ARBs or ACE inhibitors if your blood pressure is too high. These medications are also available to people with kidney disease but normal blood pressure levels due to their ability to protect the kidneys from additional damage.
If you’ve got both type 2 diabetes and kidney disease, you may be offered sodium-glucose cotransporter-2 inhibitors. This medication can help to stop the kidneys from reabsorbing glucose, which can lower blood sugar levels and offer protective benefits to the kidneys.
Certain glucagon-like peptide 1 or GLP-1 medications have been shown to be beneficial at slowing down the progression of diabetic kidney disease so this may be another option your healthcare team will discuss with you.
Other Treatments For Diabetic Kidney Disease
Your medical team may advise you to limit the amount of fluids you drink and/or recommend avoiding certain foods. If this is the case for you, you’ll receive personalised support from a dietitian to ensure that you’re getting the nutrients you need to stay healthy.
Kidney failure happens during end-stage kidney disease, and if your condition advances to this stage, you may need dialysis or a transplant. However, the great news is that more people are being diagnosed early and treatments have improved hugely over recent years, which means that fewer people are experiencing kidney failure. Kidney disease is a common health condition, but it’s now rare for it to develop into kidney failure with the right support, treatments and lifestyle changes.
How To Minimise The Risk Of Developing Kidney Disease
There are many steps that can help you reduce your chances of developing kidney damage from diabetes. Keeping your blood sugar levels within range is really important and testing regularly is key to understanding your levels and making adjustments as needed.
Other steps you can take include:
- Keeping your blood pressure within an ideal range
- Stopping smoking
- Staying active and eating a balanced diet
- Maintaining a healthy weight
- Attending all medical appointments
- Discussing medication options with your GP
It’s not possible to reverse kidney damage once it has developed; however, these steps can also help prevent further damage from occurring if you have been diagnosed with kidney disease.
FAQs
What role do the kidneys play in the human body?
Kidneys are fist-sized organs which are responsible for filtering the blood and removing excess waste and fluids via urine. Most people have two kidneys, and they’re located below the ribs in the lower back. If your kidneys aren’t functioning properly, fluids and waste products can build up, causing a range of symptoms including nausea, fatigue, and swelling.
Why do some people with diabetes develop kidney disease?
Kidney damage from diabetes is caused when elevated blood sugar levels start to damage the filters and blood vessels within the kidneys themselves. High blood pressure can also cause kidney disease, which is another reason why diabetes and kidney disease are so closely connected, as it’s something many people with diabetes also experience.
How many people with diabetes will develop diabetic kidney disease?
Not everyone with diabetes will develop kidney damage, however the condition does increase your risk of kidney disease. It is thought that around 25% of people living with diabetes will experience some form of kidney damage, however early detection can prevent it from developing and progressing.
