Overview

Diabetic nephropathy, also known as diabetic kidney disease, is a complication of diabetes that affects the kidneys' ability to filter waste and excess fluid from the blood. High blood sugar levels over time can damage the small blood vessels in the kidneys, gradually reducing their filtering capacity. High blood pressure can further increase the risk of kidney damage.

Early diabetic nephropathy may not cause noticeable symptoms. This makes regular kidney function tests important for people living with diabetes. Early diagnosis and appropriate diabetic nephropathy treatment can help slow the progression of kidney damage and reduce the risk of complications.

At Sarvodaya Hospital, patients seeking diabetic kidney disease treatment can consult a qualified specialist for an assessment of kidney function, blood sugar levels and blood pressure. The treatment plan depends on the stage of kidney disease, existing medical conditions and the patient's individual needs.

Symptoms of Diabetic Nephropathy

• Protein in urine: Increased albumin, a type of protein, may appear in the urine when the kidney's filtering units become damaged.
• Swelling: Fluid retention may cause swelling around the feet, ankles, legs or face.
• Changes in urination: Some people may notice changes in the frequency or amount of urine.
• Persistent tiredness: Reduced kidney function may contribute to fatigue.
• Poor appetite or nausea: These symptoms can occur as kidney disease advances.
• High blood pressure: Kidney damage and hypertension can worsen each other.
• Breathlessness: Fluid accumulation or associated heart problems may cause difficulty breathing in advanced cases.

Causes of Diabetic Nephropathy

• High Blood Sugar Levels
• High Blood Pressure
• Long-Term Diabetes
• Other Health Factors

Diagnosis of Diabetic Nephropathy

Diabetic nephropathy diagnosis usually involves blood and urine tests, a review of medical history and an assessment of blood pressure.

• Urine Albumin-to-Creatinine Ratio (UACR) : This urine test measures the amount of albumin relative to creatinine. Higher-than-normal albumin levels may indicate kidney damage.
• Serum Creatinine and Estimated Glomerular Filtration Rate (eGFR) : A blood test measures serum creatinine, which helps doctors estimate how effectively the kidneys filter blood.
• Blood Sugar and HbA1c Tests: Blood glucose testing and HbA1c measurements help assess current and longer-term blood sugar control.
• Blood Pressure Assessment: Regular blood pressure measurements help identify hypertension, which can contribute to kidney damage and increase the risk of cardiovascular complications.
• Additional Investigations: Depending on the findings, a nephrologist may recommend a urine examination, kidney ultrasound or other investigations.

Benefits of Early Diabetic Kidney Disease Management

• Slow the progression of kidney damage
• Help reduce protein loss through urine
• Support kidney function through blood sugar and blood pressure control
• Reduce the risk of cardiovascular complications
• Enable timely treatment adjustments through regular monitoring
• Preserve remaining kidney function
• Reduce the risk of further kidney deterioration
• Support long-term health through appropriate specialist care

Complications if Left Untreated

• Progressive loss of kidney function.
• Increasing levels of protein in the urine.
• Fluid retention and swelling.
• Difficult-to-control high blood pressure.
• Electrolyte imbalances, including abnormal potassium levels.
• Anaemia is associated with chronic kidney disease.
• Increased risk of cardiovascular disease.
• Kidney failure requiring dialysis or kidney transplantation in advanced cases.

Prevention and Lifestyle Modifications

• Monitor blood sugar: Follow the recommended glucose testing schedule and attend HbA1c reviews.
• Control blood pressure: Check blood pressure regularly and take prescribed medicines as directed.
• Attend kidney screening: Complete the recommended urine albumin and eGFR tests.
• Follow a balanced diet: Limit excess salt and follow dietary advice suited to your diabetes and kidney function.
• Stay physically active: Choose suitable activities based on your health and your doctor's advice.
• Avoid tobacco: Smoking cessation supports kidney and cardiovascular health.
• Review medicines: Tell your doctor about all medicines, supplements and herbal products you take. Some medicines, including certain anti-inflammatory painkillers, may be unsuitable for people with kidney disease.
• Maintain follow-up appointments: Regular reviews help the medical team identify changes before symptoms become noticeable.

When Should You See a Doctor?

• Urine tests show persistent protein or albumin.
• Blood tests indicate reduced kidney function.
• Blood pressure remains above the recommended range.
• You notice swelling in your feet, ankles or face.
• You experience persistent changes in urination or unexplained fatigue.
• Your doctor identifies worsening kidney function or complications.

Pre- and Post-Treatment Care

Pre-Treatment

• Review your diabetes history, blood pressure and current medicines.
• Check serum creatinine, eGFR, urine albumin and other relevant test results.
• Assess blood glucose control and HbA1c levels.
• Review other conditions, including heart disease and hypertension.
• Explain the treatment plan, possible side effects and monitoring requirements.

Post-Treatment

• Repeat blood and urine tests at intervals recommended by your doctor.
• Regular monitoring of blood pressure and blood glucose.
• Review of medicines and their doses as kidney function changes.
• Monitoring of blood potassium and other relevant blood results.
• Dietary guidance based on kidney function and nutritional needs.
• Assessment for complications if the disease progresses.