Diabetic Nephropathy: Symptoms, Causes & Treatment

Diabetes is a prevalent chronic condition that impacts millions of individuals worldwide. It is known to have a number of possible consequences. One of the most serious and often overlooked complications is diabetic nephropathy, a condition that affects the kidneys. While diabetic nephropathy seldom occurs in the first ten years after diagnosis in individuals with Type 1 diabetes, kidney damage can already be present in certain Type 2 diabetics at the time of diagnosis.

Understanding Diabetic Nephropathy

Diabetic nephropathy, or diabetic kidney disease, is a long-term complication of diabetes that primarily affects the kidneys. This medical condition arises when diabetes damages the small blood vessels and functional units within the kidneys, reducing their ability to optimally filter waste and excess fluids from the blood. Over time, this can lead to kidney dysfunction and, in severe cases, End-Stage Renal Disease, requiring dialysis or a kidney transplantation for survival.

Diabetic Nephropathy Symptoms

Diabetic nephropathy often develops silently, progressing without noticeable symptoms in its early stages. However, as the condition advances, the following diabetic nephropathy symptoms may become apparent:

• High Blood Pressure (BP) – Uncontrolled hypertension is a common sign of diabetic nephropathy, as damaged kidneys struggle to regulate blood pressure effectively.
• Swelling – Accumulation of fluid in the legs, ankles, and face due to the impaired ability of the kidneys to remove excess fluids.
• Foamy Urine – One of the signs of diabetic nephropathy is an increased protein content in the urine, which may cause foamy or frothy urine.
• Reduced Urine Output – As the kidneys’ function deteriorates, urine production may decrease.
• Fatigue – Anemia, often associated with diabetic nephropathy, can lead to fatigue and weakness.
• Nausea and Vomiting – As waste products accumulate in the blood, individuals may experience gastrointestinal symptoms like nausea and vomiting.
• Loss of Appetite – A lack of interest in food can occur as a result of nausea and other metabolic imbalances.
• Itchy Skin – Kidney dysfunction can lead to the buildup of toxins in the blood, causing itching and skin problems.

Diabetic Nephropathy Causes

The primary cause of diabetic nephropathy is diabetes itself, particularly when blood glucose levels are not well controlled. There are around one million nephrons in each of our kidneys. Nephrons are tiny organelles that remove waste from the blood. Nephrons can become thicker and scarred as a result of diabetes, which reduces their capacity to filter waste and eliminate fluid from the body. They start to leak albumin, a kind of protein, into their urine as a result.  

High blood pressure and blood sugar are suspected to be contributing factors to diabetic nephropathy causes, while the precise cause of this condition in diabetics is uncertain. Two factors that can harm the kidneys and impair their ability to filter waste and eliminate water from the body are persistently high blood pressure and blood sugar.

Risk Factors of Diabetic Nephropathy

While diabetes is the major risk factor for diabetic nephropathy, certain factors can increase the likelihood of developing this condition:

• The risk of diabetic nephropathy is significantly higher when blood sugar levels are consistently elevated and poorly managed.
• Hypertension can exacerbate kidney damage in individuals with diabetes.
• A family history of kidney diseases can increase the risk of developing diabetic nephropathy.
• The longer an individual has diabetes, the higher the risk of diabetic nephropathy.
• Some people may have a genetic predisposition that makes them more susceptible to diabetic nephropathy.

Diabetic Nephropathy Diagnosis

Early detection of diabetic nephropathy is crucial for effective management. Several diagnostic tests and assessments can help in identifying this condition:

• Urine Tests – The presence of protein (proteinuria) in the urine is usually an early sign of kidney damage. Regular urine tests can monitor changes in protein levels.
• Blood Pressure Monitoring – High blood pressure is both a symptom and a risk factor for diabetic nephropathy. Frequent blood pressure checks are essential.
• Blood Tests – Measuring serum creatinine and estimating glomerular filtration rate (eGFR) can provide insights into kidney function. One common test is a blood albumin test. When albumin is seen in the blood, the kidneys are not doing their job of retaining protein.
• Imaging tests – The size and composition of the kidneys may be seen by X-rays and ultrasounds. The efficiency of blood flow within the kidneys may be seen with CT and MRI studies. Additional imaging tests can also be required.
• Kidney Biopsy – In some cases, a kidney biopsy may be necessary to assess the extent of damage and guide treatment decisions.

Diabetic Nephropathy Treatment

Diabetic nephropathy is a serious medical complication of diabetes that affects the kidneys and can lead to end-stage renal disease if left untreated. Diabetic nephropathy treatment involves a multifaceted approach aimed at preserving kidney function and reducing the risk of complications. The diabetic treatment plan may include the following components:

• Medications – Treatment for diabetic nephropathy in its early stages may involve a number of medications to manage its causes:
• Blood Sugar Control – Maintaining optimal blood glucose levels through medication, lifestyle changes, and regular monitoring is essential in preventing further kidney damage.
• Blood Pressure Management – Controlling hypertension with medications and lifestyle modifications is crucial to slow the progression of diabetic nephropathy.
• Lower High Cholesterol – Eat more soluble fiber, cut back on trans fats, consume foods high in omega-3 fatty acids, and minimize saturated fats—which are mostly found in full-fat dairy products and red meat and can elevate your blood cholesterol.
• Controlling Protein Albumin in the Urine – Adhere to dietary modifications and strive to keep a healthy weight. Conditions that affect kidney function can be managed by losing weight; diabetes and blood pressure medications can help reduce proteinuria (the accumulation of protein in the urine); and dialysis, which uses a machine to filter and purify blood, is a final option.

Advanced Diabetic Nephropathy Treatment

When kidney disease reaches an advanced stage and eventually results in renal failure, the patient’s doctor will provide targeted therapy to manage kidney function, including:

• Dialysis – It is a medical procedure in which a machine filters and cleanses blood. When the kidneys are unable to function properly, this helps maintain the balance of the fluids and electrolytes.
• Kidney Transplant – This surgical process involves replacing a deceased or living donor’s healthy kidney with the kidney of a patient whose kidneys are no longer functioning normally.

Why Choose Wockhardt Hospitals? 

Our leading healthcare institution – Wockhardt Hospitals – is well-known for its dedication to qualitative and patient-centered treatment. With its state-of-the-art diagnostic and therapeutic facilities, the hospital guarantees that its patients get the best possible care. In order to improve their overall experience, patients at Wockhardt Hospitals may anticipate personalized treatment concerning their particular medical requirements and preferences.