Diabetic Kidney Disease
- Alyssa Magallon
- Jul 27
- 3 min read
Authors:
Tejwinder Sandhu, Touro University - California, US Melanie Ta, Jacksonville University - Jacksonville, US
Last Updated: July 25, 2025
What is Diabetic Kidney Disease?
Diabetic Kidney Disease, formerly known as diabetic nephropathy, is a serious complication of diabetes that affects the kidneys. It develops when high blood sugar levels damage the kidneys over time. Elevated sugar levels and their byproducts can harm small structures in the body, such as the tiny blood vessels found in your kidneys, feet, and eyes. In the kidneys, damage and inflammation from sugar mainly occur at the glomerulus (the filtering unit). Inflammation leads to many changes in the glomerulus that can be seen under a microscope. These changes contribute to the complications of Diabetic Kidney Disease, such as proteinuria (protein in the urine) and high blood pressure.
Who is at risk for Diabetic Kidney Disease?
The leading cause of end-stage renal disease (ESRD) in developed countries is Diabetic Kidney Disease. It affects individuals with either type 1 diabetes mellitus (T1DM) or type 2 diabetes mellitus (T2DM). The risk increases if your blood sugar levels are not well controlled. Having diabetes for many years also increases the chance of damaging your kidneys. Other risk factors include being overweight, smoking, and having a family history of kidney disease. Certain groups, like African Americans, Hispanics, and American Indians, are at a higher risk of developing this condition.
What are the signs and symptoms of Diabetic Kidney Disease?
Signs and symptoms of Diabetic Kidney Disease are nonspecific. Early in the disease, an individual may not have any symptoms at all. Common symptoms may include:
Foamy urine (proteinuria) – Due to protein in the urine
Swelling (edema) – Found throughout the body, including legs and face
Weight gain – Due to excess fluid in the body
High blood pressure (hypertension)
How is Diabetic Kidney Disease diagnosed?
Diabetic Kidney Disease is usually suspected based on the medical history, clinical examination, and blood and urine tests measuring protein levels in urine. Increased proteinuria (protein in the urine) is an early sign of declining kidney function. Patients with type 1 or type 2 diabetes mellitus should have proteinuria checked at least once a year. A kidney biopsy is required to confirm the diagnosis. A kidney biopsy is a procedure where a doctor takes a small sample of kidney tissue using a needle and studies the sample under a microscope.
How is Diabetic Kidney Disease treated?
Diabetic Kidney Disease treatment guidelines focus on modifying risk factors, controlling blood sugar levels, and managing blood pressure. Lifestyle changes are key and include limiting salt in your diet, quitting smoking, and maintaining a healthy weight with regular exercise and physical activity. Continuing treatment of diabetes and maintaining blood sugar levels within the normal range is essential to limit the damage to your kidneys. Medications called SGLT2 inhibitors (such as empagliflozin, dapagliflozin) help maintain blood sugar levels by removing sugar in your urine and provide protective effects on your kidneys. Keeping your blood pressure in a good range with medications like ACE inhibitors (such as Lisinopril) or ARBs (such as Losartan) is very important, as these also have protective benefits for your kidneys.
See your healthcare provider regularly and follow your treatment plan to prevent further damage to the kidneys. Ongoing monitoring is essential. Patients should also follow up for their diabetes management with routine blood tests, urine tests, and eye exams. Know you number! Meaning know your level of kidney function, the values associated with it and track them, so that you can ask your doctor about any changes you see and prompt them to discuss with you what you can do to prevent further damage. Regular checkups and following your treatment plan are key to protecting your kidneys and keeping them working well.
Clinical trials for Diabetic Kidney Disease:
New treatments and therapies are being developed for kidney diseases. Ask your doctor if you want to participate in a clinical trial for Diabetic Kidney Disease. More information is available at: www.enrollmypatient.org
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