Diabetic nephropathy (patient information): Difference between revisions
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A kidney biopsy confirms the diagnosis. However, your doctor can diagnose the condition without a biopsy if you meet the following three conditions: | A kidney biopsy confirms the diagnosis. However, your doctor can diagnose the condition without a biopsy if you meet the following three conditions: | ||
1. Persistent protein in the urine | *1. Persistent protein in the urine | ||
2. Diabetic retinopathy | *2. Diabetic retinopathy | ||
3. No other kidney or renal tract disease | *3. No other kidney or renal tract disease | ||
A biopsy may be done, however, if there is any doubt in the diagnosis. | A biopsy may be done, however, if there is any doubt in the diagnosis. | ||
Revision as of 18:40, 23 November 2009
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What is Diabetic nephropathy?
Diabetic nephropathy is kidney disease or damage that results as a complication of diabetes.
What are the symptoms of Diabetic nephropathy?
Early stage diabetic nephropathy has no symptoms. Over time, the kidney's ability to function starts to decline. Symptoms develop late in the disease and may include:
- Fatigue
- Foamy appearance or excessive frothing of the urine
- Frequent hiccups
- General ill feeling
- Generalized itching
- Headache
- Nausea and vomiting
- Poor appetite
- Swelling of the legs
- Swelling, usually around the eyes in the mornings; general body swelling may occur with late-stage disease
- Unintentional weight gain (from fluid buildup)
What are the causes of Diabetic nephropathy?
The exact cause of diabetic nephropathy is unknown, but it is believed that uncontrolled high blood sugar leads to the development of kidney damage, especially when high blood pressure is also present. In some cases, your genes or family history may also play a role. Not all persons with diabetes develop this condition.
Each kidney is made of hundreds of thousands of filtering units called nephrons. Each nephron has a cluster of tiny blood vessels called a glomerulus. Together these structures help remove waste from the body. Too much blood sugar can damage these structures, causing them to thicken and become scarred. Slowly, over time, more and more blood vessels are destroyed. The kidney structures begin to leak and protein (albumin) begins to pass into the urine.
Diabetic nephropathy generally goes along with other diabetes complications including high blood pressure, retinopathy, and blood vessel changes.
Who is at risk for Diabetic nephropathy?
Persons with diabetes who have the following risk factors are more likely to develop this condition:
- African American, Hispanic, or American Indian origin
- Family history of kidney disease or high blood pressure
- Poor control of blood pressure
- Poor control of blood sugars
- Type 1 diabetes before age 20
- Smoking
How to know you have Diabetic nephropathy?
The main sign of diabetic nephropathy is persistent protein in the urine. (Protein may appear in the urine for 5 to 10 years before other symptoms develop.) If your doctor thinks you might have this condition, a microalbuminuria test will be done. A positive test often means you have at least some damage to the kidney from diabetes. Damage at this stage may be reversible. The test results can be high for other reasons, so it needs to be repeated for confirmation.
High blood pressure often goes along with diabetic nephropathy. You may have high blood pressure that develops rapidly or is difficult to control.
Laboratory tests that may be done include:
- BUN
- Serum creatinine
The levels of these tests will increase as kidney damage gets worse. Other laboratory tests that may be done include:
- 24-hour urine protein
- Blood levels of phosphorus, calcium, bicarbonate, PTH, and potassium
- Hemoglobin
- Hematocrit
- Protein electrophoresis - urine
A kidney biopsy confirms the diagnosis. However, your doctor can diagnose the condition without a biopsy if you meet the following three conditions:
- 1. Persistent protein in the urine
- 2. Diabetic retinopathy
- 3. No other kidney or renal tract disease
A biopsy may be done, however, if there is any doubt in the diagnosis.
When to seek urgent medical care
Treatment options
Diseases with similar symptoms
Where to find medical care for Diabetic nephropathy
Directions to Hospitals Treating Diabetic nephropathy
Prevention of Diabetic nephropathy
What to expect (Outlook/Prognosis)
Sources
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