Symptoms of diabetes nephropathy
SUBSCRIBE Diabetic nephropathy or kidney disease Medically reviewed by Deborah Weatherspoon, Ph.D., MSN — Written by Tom Seymour — Updated on January 18, 2022 What is it? Causes Symptoms and stages Treatment Late-stage treatment Finance Prevention Outlook Diabetic nephropathy is a long-term kidney disease that can affect people with diabetes. It occurs when high blood glucose levels damage how a person’s kidneys function. Diabetic nephropathy is a kind of chronic kidney disease (CKD). The kidneys help regulate the levels of fluids and salts in the body, which is vital for controlling blood pressure and protecting cardiovascular health. When a person has diabetes, whether type 1, type 2, or gestational diabetes, their body cannot use or produce insulin as it should. Gestational diabetes occurs during pregnancy and may increase the risk of type 2 diabetes later in life. Diabetes results in high blood sugar levels. Over time, these high glucose levels can damage various areas of the body, including the cardiovascular system and kidneys. The kidney damage that results is known as diabetic nephropathy. Diabetic nephropathy is a major causeTrusted Source of long-term kidney disease and end-stage renal disease (ESRD). In ESRD, the kidneys no longer work well enough to meet the needs of daily life. ESRD can lead to kidney failure with potentially life-threatening consequences. This article looks at how diabetes can affect the kidneys, the treatment available, and how to reduce the risk. Learn more about type 1 and type 2 diabetes. What is diabetic nephropathy? Diabetic nephropathy is a possible complication of diabetes. Nephropathy can affect people with any type of diabetes because it results from damage due to high blood glucose. High blood glucose levels affect the arteries in the body, and the kidneys filter blood from those arteries. Authors of a studyTrusted Source from 2016 note that 20–40% of people with diabetes develop some kind of kidney disease. Tests may show that a person has one or both of the following: High levels of albumin in the urine: When the kidneys are healthy, the urine should contain none of the proteinTrusted Source known as albumin. A low glomerular filtration rate (GFR): A key function of the kidneys is to filter the blood. Kidney damage affects their ability to do this. Ideally, the kidneys should function at 100%, or have a GFR of 100Trusted Source. If tests show that the GFR is 60% or above, a doctor will not diagnose kidney disease. From 15–60%, there is kidney disease. Below 15% indicates kidney failure. ESRD is the last stage of kidney disease. Diabetic nephropathy is the most frequent cause of ESRD in the United States. Some 40–50%Trusted Source of all cases of ESRD relate to diabetes. A person with ESRD will require dialysis. Managing blood sugar levels can reduce the risk. Whether a person has type 1 or type 2 diabetes, they can reduce the risk of diabetic nephropathy by: monitoring blood glucose levels and keeping them within the target range having a healthful diet that is low in sugar and salt getting regular exercise following a treatment plan, which may include the use of insulin or other medications maintaining a healthy weight What is chronic kidney disease? Find out more here. Causes Damage to the kidneys puts stress on these vital organs and prevents them from working properly. When this happens: the body starts to lose protein through the urine the kidneys cannot remove waste products from the blood the kidneys cannot maintain healthy fluid levels in the body Diabetic nephropathy develops slowly. According to one study, a third of people show high levels of albumin in their urine 15 yearsTrusted Source after a diagnosis of diabetes. However, fewer than half of these people will develop full nephropathy. Statistics have suggested that kidney disease is uncommon in people who have had diabetes for less than 10 years. Also, if a person has no clinical signs of nephropathy 20–25 years after diabetes starts, they have a low chance of developing it thereafter. Diabetic nephropathy is less likely if a person with diabetes manages their glucose levels effectively. High blood glucose levels increase the risk of high blood pressure because of the damage to blood vessels. Having high blood pressure, or hypertension, may contribute to kidney disease. Other risk factors Other risk factors include: Smoking: Kidney damage may result from a linkTrusted Source between smoking and higher levels of inflammation. While the link between smoking and diabetes remains unclear, there appears to be a greater incidence of diabetes, as well as hypertension and kidney disease, among people who smoke. Age: Kidney disease, and especially a low GFR is more common in people aged 65 yearsTrusted Source and above. Sex: The condition is more common in men than in women. Race, ethnicity, or both: It is more common in African Americans, Native Americans, and Asian Americans. Health conditions: Having obesity, chronic inflammation, high blood pressure, insulin resistance, and elevated levels of blood lipids (fats) can all contribute to kidney disease. Some of these risks either are or appear to be contributing factors to or complications of diabetes. Diabetic nephropathy is not the same as diabetic neuropathy, which affects the nervous system. Learn more here about diabetic neuropathy and peripheral neuopathy. Symptoms and stages In the early stages of diabetic nephropathy, a person may not notice any symptoms. However, changes in blood pressure and the fluid balance in the body may already be present. Over time, waste products can build up in the blood, leading to symptoms. Stages A doctor may break down the stages of kidney disease, depending on the GFR, which also represents the percentage of effective kidney function. Stage 1: Kidney damage present but normal kidney function and a GFR of 90% or above. Stage 2: Kidney damage with some loss of function and a GFR of 60–89%. Stage 3: Mild to severe loss of function and a GFR of 30–59%. Stage 4: Severe loss of function and GFR of 15–29%. Stage 5: Kidney failure and a GFR of under 15%. Symptoms A person with stage 4 or 5 nephropathy may notice symptoms such as dark urine. In the early stages, a person may not notice any symptoms. At stage 4 or 5, they may feel unwell and experience the following symptoms: swollen ankles, feet, lower legs, or hands due to water retention darker urine due to blood in the urine shortness of breath fatigue due to lack of oxygen in the blood nausea or vomiting a metallic taste in the mouth Complications of late-stage kidney disease include cardiovascular disease. Following a treatment plan for diabetes and attending regular health checks can help a person with diabetes control their blood sugar levels, reduce the risk of kidney problems, and find out early if they need to take action. Screening involves a person taking a urine test to check for proteins in the urine. However, having proteins in the urine does not necessarily indicate kidney disease, as it could also be due to a urinary tract infection.