Diabetic Nephropathy – Symptoms and Causes
Overview
Diabetic nephropathy affects about 1 in 3 people with diabetes in the United States. This serious kidney condition can develop in both type 1 and type 2 diabetes patients.
The kidneys play a crucial role in filtering blood. They remove waste products, chemicals, and extra fluid that the body doesn’t need, sending these materials out through urine. When diabetes damages this filtering system, waste builds up in the blood.
Without proper management, this condition can progress to kidney failure, also known as end-stage kidney disease. This life-threatening situation may require either dialysis or a kidney transplant to sustain life.
Signs of Kidney Problems
Diabetic kidney disease often starts without any signs. As the condition gets worse, you may notice:
- Rising blood pressure that is hard to control
- Swelling in your feet, ankles, hands, or around your eyes
- Urine that looks foamy
- Needing to urinate more or less than usual
- Feeling confused or having trouble thinking clearly
- Breathing problems
- Reduced hunger
- Feeling sick to your stomach or throwing up
- Skin that itches
- A metallic taste in your mouth or bad breath
- Feeling tired or weak
These symptoms usually appear in later stages of kidney damage. In early stages, the only clue may be protein in the urine, which is often found during routine lab tests.
When to Contact Your Doctor
See your doctor if you notice any kidney problem symptoms. If you have diabetes, get yearly kidney function tests. Don’t wait for symptoms to appear before getting checked.
Causes
Your kidneys contain millions of tiny filtering units called glomeruli. These small blood vessel clusters work to remove waste products from your blood.
When working properly, these filters keep important substances in your bloodstream while removing toxins that your body doesn’t need. This filtering process is essential for maintaining health and balancing chemicals in your body.
Diabetes can harm your kidneys when blood sugar levels stay high over time.
When diabetes isn’t well controlled, the high blood sugar damages the small blood vessels in your kidneys that filter waste. This damage makes it harder for your kidneys to clean your blood properly.
Risk Factors
Several factors can increase your chance of developing diabetic nephropathy if you have diabetes:
- Uncontrolled high blood sugar (hyperglycemia)
- High blood pressure that isn’t managed well
- Smoking habits
- Elevated cholesterol levels
- Obesity
- Family history of both diabetes and kidney disease
Complications
Diabetic nephropathy can lead to several serious health problems that develop gradually. Fluid retention may occur, causing swelling in limbs, increased blood pressure, or fluid buildup in the lungs.
Hyperkalemia, a condition where potassium levels in the blood become too high, is another possible complication. Cardiovascular problems may also develop, increasing stroke risk.
People with diabetic nephropathy often experience anemia—a reduction in oxygen-carrying red blood cells. This can cause fatigue and weakness.
Pregnant individuals face heightened risks for both themselves and their developing babies when nephropathy is present. The most severe outcome is end-stage kidney disease, where kidney damage becomes irreversible.
Ways to Prevent Diabetic Kidney Problems
Good diabetes control is your best defense. Keep your blood sugar levels within target ranges as much as possible. This can prevent kidney damage or slow its progression if it has already started.
Control your blood pressure. High blood pressure can worsen kidney problems in people with diabetes. Work with your healthcare provider to find effective treatments.
Be careful with over-the-counter medications. Some common pain relievers like aspirin, ibuprofen, and naproxen can harm your kidneys if you have diabetic kidney problems. Always read labels carefully and follow directions.
Maintain a healthy weight through regular physical activity. If you need to lose weight, discuss effective strategies with your healthcare team rather than trying extreme diets.
Stop smoking. Smoking damages blood vessels and can make kidney problems worse. If you smoke, ask your doctor about quitting methods that might work for you. These include support groups, counseling, medication options, and nicotine replacement therapy.
Take all prescribed medications as directed. Don’t skip doses or stop taking medication without talking to your doctor first.
Eat a kidney-friendly diet. Your doctor may recommend limiting protein intake, reducing salt consumption, controlling potassium and phosphorus levels, and staying well-hydrated.
