Diabetic Nephropathy (Kidney Disease)

What is diabetic kidney disease?

Diabetic kidney disease (DKD) is kidney disease that is due to diabetes. It is also called diabetic nephropathy. Nephropathy means your kidneys are not working well.

Both type 1 and type 2 diabetes are the most common cause of kidney disease. 

There are 5 stages of DKD. The final stage is kidney failure (end-stage renal disease or ESRD). Going from one stage to the next can take many years.

What causes diabetic kidney disease?

Both high blood pressure and high blood sugar damage the kidneys.

  • As kidney disease gets worse, physical
    changes in the kidneys often lead to higher blood pressure.
  • Uncontrolled high blood pressure can speed the progress toward ESRD.
  • High blood sugar linked to diabetes
    damages the kidney in several different ways. Mainly, it damages the blood vessels
    that filter the blood to make urine.

What are the symptoms of diabetic kidney disease?

At first, most people with DKD don’t have symptoms. Having your
kidney function checked is the only way to know if there are problems. Over the years,
as kidney disease develops, small amounts of the blood protein albumin begin to show in
your urine. This first stage of chronic kidney disease is called moderately increased
albuminuria (microalbuminuria). The kidneys can still filter waste during this
stage.

As the disease worsens, more albumin leaks into the urine. This stage
may be called severely increased albuminuria (macroalbuminuria). As the albumin
increases, the kidneys can’t cleanse the blood as well. Wastes are left in the blood.
Blood pressure often rises as well.

It is rare for kidney damage to happen in the first 10 years of
diabetes. Kidney failure often happens 15 to 25 years after the first symptoms of
diabetes. If you have had diabetes for more than 25 years without any signs of kidney
failure, your risk of having it decreases.

How is diabetic kidney disease diagnosed?

If you have diabetes, it’s
important to be checked regularly for kidney disease. To do this, your healthcare
provider will monitor the waste products in your blood and urine. Your provider will
test your urine to check for a protein called albumin. Normally, urine should not have
any albumin. Even a small amount of albumin in your urine is a sign of early kidney
damage. The main waste product checked for in the blood is known as creatinine.

If kidney disease is found, your
healthcare provider will address it as part of your diabetes treatment plan.