Definition
Diabetic nephropathy is a complication of diabetes . If you have this condition, your kidney loses its ability to function properly. The condition is characterized by high protein levels in the urine.
Symptoms
Early stage diabetic nephropathy has no symptoms. Symptoms develop late in the disease and may be a result of kidney failure or eliminating high amounts of protein in the urine.
Symptoms may include:
Keep reading...
Definition
Diabetic nephropathy is a complication of diabetes . If you have this condition, your kidney loses its ability to function properly. The condition is characterized by high protein levels in the urine.
Symptoms
Early stage diabetic nephropathy has no symptoms. Symptoms develop late in the disease and may be a result of kidney failure or eliminating high amounts of protein in the urine.
Symptoms may include:
Keep reading...
Causes
Each kidney is made of hundreds of thousands of units called nephrons. Each nephron has a cluster of blood vessels called a glomerulus. The glomerulus filters blood and forms urine, which drains down into the ureter.
The earliest detectable change in the course of diabetic nephropathy is a thickening in the glomerulus. At this stage, the kidney may start allowing more albumin (protein) than normal in the urine, and this can be detected by sensitive tests for albumin. This stage is called "microalbuminuria" (micro refers to the small amounts of albumin).
As diabetic nephropathy progresses, increasing numbers of glomeruli are destroyed. Now the amounts of albumin being excreted in the urine increases, and may be detected by ...
Keep reading...
Treatment
The goals of treatment are to slow the progression of kidney damage and control related complications.
The main treatment, once proteinuria is diagnosed, is keeping blood pressure under control (to levels less than 130/80.) If possible, a type of blood pressure medicine, either angiotensin converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs), should be used. These drugs reduce urine protein levels and slow down the diabetic nephropathy. Many studies have suggested that a combination of these two types of drugs may be best.
Uncontrolled high blood pressure will worsen kidney, eye, and blood vessel damage in the body. Controlling your high blood pressure is the most effective way of slowing kidney damage from diabetic nephropathy. It is also very important to control lipid levels, maintain a healthy ...
Keep reading...
Other Names
Kimmelstiel-Wilson disease; Diabetic glomerulosclerosis; Diabetic kidney disease
Outlook (Prognosis)
Once large amounts of protein begin to appear in the urine or the serum creatinine begins to rise, diabetic nephropathy typically continues to slowly worsen.
Complications of chronic kidney failure are more likely to occur earlier, and progress more rapidly, when it is caused by diabetes than other causes. Even after dialysis or transplantation, people with diabetes tend to do worse than those without diabetes.
Prevention
Blood glucose levels should be controlled as closely as possible in people with diabetes. Controlling blood pressure, cholesterol, and weight is just as important.
Exams and Tests
The first laboratory abnormality is a positive microalbuminuria test . This often means you have at least some damage to the kidney from diabetes. Damage at this stage may be reversible.
Most often, the diagnosis is suspected when a routine urinalysis shows too much protein in the urine (proteinuria) of someone with diabetes. This test may also show glucose in the urine, especially if blood sugar is poorly controlled.
High blood pressure may be present or develop rapidly. It may be difficult to control. Serum creatinine and BUN eventually may increase as kidney damage gets worse.
A kidney biopsy confirms the diagnosis. However, this test is not done if you have shown increasing protein in the urine over time and the presence of diabetic retinopathy during an eye exam. The biopsy may be done if there is any doubt in the diagnosis, and to study the extent of the disease.
Keep reading...
