Diabetic nephropathy is a progressive kidney disease that can affect people with diabetes. It is a serious complication of type 1 diabetes and type 2 diabetes, also known as diabetic kidney disease.
It is observed in high blood sugar levels, which subsequently impair the proper function of the kidneys. Diabetic nephropathy is a type of chronic kidney disease that is characterized by the maintenance of high glucose levels for many years, leading to changes in the nephrons. Therefore, people with diabetes often release protein in their urine. The most common protein released is albumin.
One of the first signs of diabetic kidney disease is increased urinary albumin. When only small amounts of it are found in the urine, this is called microalbuminuria. Characteristic of this health problem is weight gain and swelling of the ankles.
The natural course of diabetic kidney disease includes glomerular hyperfiltration, progressive albuminuria, decreased GFR, and ultimately end-stage renal disease. Diabetic nephropathy begins as glomerular hyperfiltration. Microalbuminuria then occurs, urinary albumin excretion in the range of 30 to 300 mg albumin / day. Microalbuminuria progresses to macroalbuminuria usually over years. The nephrotic syndrome (proteinuria ≥ 3 g / day) preceding the end stage of kidney disease takes an average of about 5 years, but this time is also highly variable.
Once this damage is present, the remaining kidney filters must work extra to compensate for deficiencies in the proper functioning of the system. Once the kidneys start working at less than 15% of their capacity, kidney failure is diagnosed and the patient usually goes on dialysis.
There is no specific treatment for diabetic nephropathy, but the progression of the disease can be slowed by controlling blood pressure, optimizing blood sugar levels and changing the diet. Once kidney disease is present, the most important thing to pay attention to is controlling blood pressure.