Diabetic Nephropathy: Causes, Complications and Management

Research Based
Medically reviewed by - Dr Qudsiya Raiees, MD Written by - Dr. Shaheen Shah


What is diabetic nephropathy?

Diabetic nephropathy(diabetic kidney disease)is the deterioration of kidney functioning due to long-term diabetes(high blood sugar ). It is one of the severe complications of diabetic people, ultimately leading to kidney failure.

Diabetic nephropathy(diabetic kidney disease)is the deterioration of kidney functioning due to long-term diabetes(high blood sugar ).

How diabetes affects the kidneys?

Diabetes is the condition of high levels of sugar in our bodies. In this disease, the body cannot correctly process the glucose in our body leading to the accumulation of extra glucose in the blood, which ultimately impairs the glomerular membrane(which plays a role in kidney filtration) and other nephrons (kidney’s filtering units) parts. Impaired glomeruli( groups of tiny blood vessels in the nephron) cannot correctly filter the toxins in the body fluids; as a result, toxins accumulate in the body. Over the years, the toxin accumulation has led to kidney malfunctioning 1Overview | Researched based study from


Facts about diabetic nephropathy

  • Diabetic nephropathy disturbs the kidney’s capacity to filter and remove waste fluids from our bodies.
  • Diabetic nephropathy lead to the last stage of kidney disease, and the kidneys cannot function properly.
  • The danger of acute kidney damage (AKI) in patients with diabetic nephropathy necessitates the use of nephrotoxic drugs with utmost caution.
  • Diabetes nephropathy and diabetic retinopathy(Vision loss in diabetics) are related. 9Facts | Researched based study from
  • Diabetic nephropathy patients experience kidney damage symptoms much later (after ten years ).
  • A high risk of developing diabetic nephropathy exists in some racial groups, such as African Americans, Native Americans, and Mexican Americans. 9Facts | Researched based study from
  • By controlling diabetes and high blood pressure, one can postpone diabetic nephropathy 1Facts | Researched based study from


Symptoms of diabetic nephropathy

  • Fluid retaining
  • High blood pressure
  • Swelling of the hands, feet, ankles and eyes
  • Excreting protein in the urine
  • Foam(bubbles) in urine
  • Intense urge to urinate
  • Extreme tiredness
  • Extreme weakness
  • Reduced appetite
  • Stomach problem
  • Nausea and vomiting
  • Headache
  • Sleeplessness
  • Anxiety
  • Confusion
  • Abnormal heart rate
  • Difficulty in breathing
  • Continual itching of the skin
  • Muscle spasm
  • Decreased need for diabetes medicine2Symptoms | Researched based study from


What are the causes of diabetic nephropathy ?

High blood sugar

  • Uncontrolled diabetes causes impairment of the glomeruli of the nephron responsible for filtering the toxic waste from our blood leading to diabetic nephropathy.

High blood pressure

  • Uncontrolled high blood pressure creates additional pressure in the kidney nephrons, which causes further kidney malfunction and rapid kidney damage 3Causes | Researched based study from

Risk factor

Risk factors of diabetic nephropathy

  • Smoking
  • Increased body weight
  • Hyperglycemia (high blood sugar)
  • Hypertension(high blood pressure)
  • High cholesterol in the blood
  • Have other diabetic complications such as nerve problems and eye problem
  • Having a hereditary history of kidney problem
  • Having diabetes before the age of 20 4Risk factors | Researched based study from


Diagnosis of diabetic nephropathy

Blood urea nitrogen (BUN) blood test

  • It looks at whether the kidneys are functioning properly
  • It looks for urea nitrogen level in the blood which is the kidney’s waste product to be eliminated from the body
  • An elevated level of BUN indicates some problem in the kidneys.5Diagnosis | Researched based study from

Serum creatine blood test

  • It checks for proper kidney functioning
  • It checks for the creatine levels in the blood creatine is a waste product made by the body’s muscles
  • This test is recommended by doctors when patients have painful urination or foam or bubbles in their urine.5Diagnosis | Researched based study from

Microalbuminuria urine test

  • It is a test to screen for kidney disease
  • It checks for excess albumin in the urine, and the condition is called microalbuminuria.

Kidney biopsy

  • A doctor recommends a kidney biopsy to confirm the kidney disease
  • The procedure takes small kidney tissue samples that are examined with a microscope 5Diagnosis | Researched based study from .


Different stages in diabetic nephropathy (kidney disease)

Depending on the patient’s glomerular filtration rate (GFR), the kidney disease is divided into the following stages 6Stages| Researched based study from

Stage 1 chronic kidney disease

  • Kidney impairment is present
  • Kidney functioning is normal
  • GFR rate is 90% or more

Stage 2 chronic kidney disease

  • Kidney impairment with a little loss of kidney function
  • GFR rate is 60 to 89%

Stage 3 chronic kidney disease

  • Mild to moderate loss of kidney function
  • GFR rate is 30 to 59%

Stage 4 chronic kidney disease

  • Severe loss of kidney function
  • GFR rate is 15 to 29%

Stage 5 chronic kidney disease (end-stage renal disease or end-stage kidney disease )

  • Very close to failure or complete kidney failure
  • GFR rate is below 15% 6Stages | Researched based study from


Management of diabetic nephropathy

Diabetic nephropathy is incurable, but treatments can slow the disease’s advancement.


Angiotensin receptor blockers

  • Used to treat high blood pressure and heart failure ( i.e.heart muscle does not pump enough blood)

Angiotensin-converting enzyme (ACE) inhibitors

  • Used to treat high blood pressure 8Management | Researched based study from
  • Prevents narrowing of the blood vessels


  • Prevents worsening of kidney disease
  • Reduces the GFR( glomerular filtration rate) decline
  • Reduces the risk of heart attack

Diet modification

  • Eating healthy fats such as salmons, sardines, walnuts
  • Reducing salt intake
  • Restricted protein uptake
  • Limiting potassium-containing foods like spinach, avocados and bananas
  • Limiting high-phosphorus foods like processed meat, milk, and yogurt 7Management | Researched based study from

Lifestyle modification

Regular physical exercise, walking and jogging can

  • reduce one’s blood sugar and
  • manage stress
  • Reduce the risk of heart disease
  • Delay diabetic nephropathy

Periodically doing yoga and meditation can

  • Reduce the stress in our body
  • Control blood sugar and blood pressure and
  • Slows the progression of the kidney disease

End-stage renal disease treatment


  • Dialysis is recommended for patients with kidney malfunctioning 7Management | Researched based study from
  • Dialysis performs the kidney function artificially outside of the body
  • Removes unwanted body toxins and excess fluids from the blood

Kidney transplant

  • Recommended to patients with total kidney damage
  • Surgery is performed to replace the damaged kidney with the donor’s kidney
  • The donor kidney should be a good match with the patient’s kidney 7Management | Researched based study from ,8Management | Researched based study from


Complication of diabetic nephropathy


  • increased potassium level in the blood 8Complications | Researched based study from

Diabetic retinopathy

  • It affects blood vessels of the retina and causes blindness 8Complications | Researched based study from

Pulmonary edema

  • Abnormal fluid builds up in the lungs and
  • Swelling due to fluid retention is seen in arms and legs

Cardiovascular disease

  • A disease of the blood vessels and heart 8Complications | Researched based study from
  • It can lead to stroke (cut off of blood supply to part of the brain due to blocked artery)

Bone mineral disorder

  • Calcium and phosphate levels in the blood change
  • It also causes hormonal imbalances


  • Lack of healthy RBC (red blood cells) to carry oxygen to the body’s cells

Foot sores

  • Swelling and inflammation in the foot area that does not heal easily

Pregnancy complication

  • Premature birth 8Complications | Researched based study from
  • High blood pressure in the mother
  • Causes life risks for both the mother and fetus


  • Frequent loose, watery stool

Erectile dysfunction

  • It is a sexual dysfunction in males 8Complications | Researched based study from
  • Causes difficulty in maintaining penile erection

Complete kidney damage

  • Needs dialysis and kidney transplant 8Complications | Researched based study from


Prevention of Diabetic Nephropathy.

Prevention of diabetic nephropathy

  • Maintaining a good diet with high fibre and low sodium, carbohydrate and sugar
  • Avoiding processed food high in salt
  • Controlling high blood pressure by requisite treatment
  • Maintaining the body weight
  • Exercising regularly
  • Avoiding tobacco and alcohol
  • Complete cessation of smoking
  • Reducing body stress
  • Following the treatment strategy as directed by the physician
  • Often visiting a physician to control diabetes 7Prevention | Researched based study from


Key Takeaways

  • People with diabetic nephropathy should manage their blood pressure, body weight and blood sugar.
  • Earlier starting of the diabetes treatment delays the kidney disease
  • People with diabetes should visit the physician regularly and take required precautions as recommended to prevent the kidney disease from advancing
Disclaimer: The user acknowledges that this article's information is being offered for informational purposes only. Every attempt has been made to guarantee that the article is informational and correct. If they have any doubts or questions about their health, we firmly advise our readers to visit a doctor or other healthcare professional.

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