Causes

Causes
Each kidney is made of hundreds of thousands of small units called nephrons. These structures filter blood and help eliminate waste from the body.

In people with diabetes, the nephrons slowly thicken and heal over time.

The kidneys begin to leak and protein (albumin) into the urine.
This damage can occur years before symptoms begin.
The exact cause is unknown. However, renal damage is more likely if there is poor control of diabetes and high blood pressure.
In some cases, family history may also play a role. Not all people with diabetes develop kidney problem.

People with diabetes who smoke and those with type 1 diabetes that began before age 20 are at increased risk of kidney problems.

People of Indian origin African Americans, Hispanics and Americans are also more likely to have kidney damage.

Symptoms
Often there are no symptoms and kidney damage starts and slowly worsens. Kidney damage may begin 5 to 10 years before symptoms begin.

People with more severe and prolonged (chronic) kidney disease may have symptoms such as:

More often fatigue
General ill feeling
Headache
Nausea and vomiting
Lack of appetite
Leg swelling
Signs and tests
Your doctor may order tests to detect signs of kidney problems in the early stages. Once a year, you should have a urine test. It looks for a protein called albumin in the urine escapes.

Excessive leakage of this protein is often a sign of kidney damage.
Because the test looks small amounts of albumin, sometimes called a test for microalbuminuria.
High blood pressure often goes hand in hand with diabetic nephropathy. You can have high blood pressure, which begins quickly or is difficult to control.

Your doctor will also check your kidneys with the following blood tests every year:

BUN
Serum creatinine
A kidney biopsy confirms the diagnosis. A biopsy is performed only if there is any doubt about the diagnosis.

Treatment
When kidney damage is detected in its early stages, can be slowed with treatment. Once again large quantities of protein appears in the urine, kidney damage slowly get worse.

Keeping your blood pressure under control (below 130/80) is one of the best ways to slow kidney damage.

Your doctor can prescribe medication to lower blood pressure and protect the kidneys from further damage. Often, the best types of medicine are used ACE inhibitors and angiotensin receptor blockers (ARBs).
Even if your blood pressure is normal, these drugs help slow kidney damage.
Eating a low fat diet, taking medications to control blood cholesterol, and regular exercise can also help prevent or delay kidney damage.

You can also delay kidney damage by regulating sugar levels in the blood, which can be done by:

Eating a healthy diet
Regularly taking insulin or other medications prescribed by your doctor
Learn the basic steps to manage their levels of blood sugar at home
Checking sugar levels in the blood and maintain a record of
To protect your kidneys, remember the following:

Tell your doctor about your diabetes before undergoing an MRI exam, CT scan, or otherwise is received in the dye. These dyes can further damage the kidneys.
Always talk to your doctor before taking pain NSAIDs, such as ibuprofen and naproxen. They can damage the kidneys.
Know the symptoms of urinary tract infections and treated immediately.
To treat chronic kidney disease, you need to make changes in your diet, and treat problems caused by kidney disease.

Expectations (prognosis)
Diabetic kidney disease is a major cause of illness and death in people with diabetes. It can lead to the need for dialysis or a kidney transplant.

When to Contact a Medical Professional
Call your doctor if you have diabetes and have not had a routine urinalysis to detect proteins.

Alternative Names
Kimmelstiel-Wilson disease, glomerulosclerosis, diabetic nephropathy - diabetic nephropathy