Diabetic Nephropathy
What is Diabetic Nephropathy?
Diabetic nephropathy is kidney damage that happens when high blood sugar levels harm the tiny filters in your kidneys. These filters, called nephrons, clean waste from your blood. When diabetes damages them over time, your kidneys struggle to do their job. Protein starts leaking into your urine, and waste builds up in your blood.
This condition develops slowly over many years. Most people with diabetes will not get kidney disease if they manage their blood sugar well. However, about 1 in 3 adults with diabetes does develop some form of kidney damage. The good news is that catching it early can slow or even stop the progression.
Diabetic nephropathy moves through five stages, from mild damage to kidney failure. In the earliest stages, you may have no symptoms at all. This is why regular blood and urine testing is so important. Finding kidney damage early gives you the best chance to protect your kidney function and avoid dialysis or transplant later.
Symptoms
- Swelling in your ankles, feet, legs, or hands from fluid buildup
- Foamy or bubbly urine from protein leaking into urine
- Needing to urinate more often, especially at night
- Feeling tired or weak even with enough sleep
- Loss of appetite or feeling sick to your stomach
- Trouble concentrating or thinking clearly
- Shortness of breath from fluid around your lungs
- High blood pressure that is hard to control
- Itchy, dry skin
Many people have no symptoms in the early stages of diabetic kidney disease. Damage can be happening for years before you feel anything. This is why blood tests are the only reliable way to catch this condition early.
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Causes and risk factors
High blood sugar is the main cause of diabetic nephropathy. When glucose stays elevated in your bloodstream, it damages the small blood vessels in your kidneys. This damage makes the kidney filters leak protein and stop cleaning waste properly. High blood pressure also damages kidney blood vessels and speeds up the disease. Many people with diabetes have both conditions, which doubles the risk to kidney health.
Other risk factors include having diabetes for more than 10 years, poor blood sugar control, family history of kidney disease, smoking, being overweight, and having high cholesterol. People with Type 1 or Type 2 diabetes are both at risk. However, you have more control than you might think. Managing blood sugar, blood pressure, and lifestyle factors can prevent most cases of diabetic kidney damage.
How it's diagnosed
Diabetic nephropathy is diagnosed through blood and urine tests that measure kidney function. A urine test checks for albumin, a type of protein that should not be in your urine. Small amounts of albumin in urine, called microalbuminuria, are the earliest sign of kidney damage. Blood tests measure creatinine and calculate your estimated glomerular filtration rate, or eGFR. This number tells your doctor how well your kidneys are filtering waste.
Rite Aid offers comprehensive testing for diabetic kidney disease through our flagship panel. We test albumin to creatinine ratio, creatinine levels, eGFR, cystatin C, and urine protein. These tests give you a complete picture of your kidney health. Getting tested twice a year helps you and your doctor catch problems early and adjust your treatment plan before serious damage occurs.
Treatment options
- Keep blood sugar levels in your target range through diet, exercise, and medication
- Control blood pressure with lifestyle changes and blood pressure medications if needed
- Follow a kidney-friendly diet lower in protein, sodium, and potassium
- Take ACE inhibitors or ARBs, medications that protect your kidneys and lower blood pressure
- Use SGLT2 inhibitors, diabetes medications that also protect kidney function
- Quit smoking, which damages blood vessels and speeds kidney decline
- Maintain a healthy weight through balanced eating and regular movement
- Limit alcohol intake to reduce stress on your kidneys
- Work with a dietitian who specializes in diabetes and kidney disease
- Monitor your kidney function regularly with blood and urine tests
Concerned about Diabetic Nephropathy? Get tested at Rite Aid.
- Simple blood draw at your nearest lab
- Results in days, not weeks
- Share results with your doctor
Frequently asked questions
These terms mean the same thing and are used interchangeably by doctors. Both refer to kidney damage caused by diabetes. Some doctors prefer the term diabetic kidney disease because it covers all stages of kidney damage, from mild to severe.
Early stage diabetic nephropathy can sometimes be reversed with excellent blood sugar and blood pressure control. Once kidney damage becomes more advanced, you cannot fully reverse it. However, you can slow or stop further damage with proper treatment. This is why catching it early through regular testing is so important.
If you have diabetes, you should test your kidney function at least once a year. Many experts recommend testing twice a year for better monitoring. If you already have signs of kidney damage, your doctor may want to test you more often. Regular testing helps catch changes early when treatment works best.
Protein in urine means your kidney filters are damaged and letting protein leak through. Healthy kidneys keep protein in your blood where it belongs. Even small amounts of protein, called microalbuminuria, signal early kidney damage. Finding protein in your urine early gives you the best chance to protect your kidneys.
A normal eGFR is 90 or higher. This number shows how well your kidneys are filtering waste from your blood. An eGFR between 60 and 89 may indicate early kidney damage. Below 60 means you have chronic kidney disease. Below 15 is kidney failure requiring dialysis or transplant.
No, most people with early diabetic kidney damage will not need dialysis. Catching it early and managing your blood sugar and blood pressure well can prevent progression. Only people who reach end stage kidney failure need dialysis. Proactive monitoring and treatment make a huge difference in outcomes.
Limit foods high in sodium like processed foods, canned soups, and deli meats. Reduce high potassium foods like bananas, oranges, and potatoes if your levels are elevated. Watch protein intake, especially from red meat. Work with a dietitian to create a meal plan that protects your kidneys while managing your blood sugar.
Yes, exercise is important for managing both diabetes and kidney disease. Physical activity helps control blood sugar and blood pressure, both of which protect your kidneys. Aim for 30 minutes of moderate activity most days. Talk to your doctor about the right exercise plan for your stage of kidney disease.
ACE inhibitors and ARBs are blood pressure medications that also protect kidney function in diabetes. SGLT2 inhibitors, a newer class of diabetes medication, have been shown to slow kidney disease progression. GLP-1 receptor agonists may also provide kidney protection. Your doctor will choose medications based on your individual needs.
High blood pressure damages the small blood vessels in your kidneys, making them less able to filter waste. When combined with high blood sugar, the damage happens faster and becomes more severe. Keeping blood pressure below 130/80 is one of the most important things you can do to protect your kidneys. Many people need medication to reach this goal.