Understanding Diabetic Nephropathy: Symptoms, Diagnosis, and Treatment Options

Diabetic nephropathy is a serious complication of diabetes that affects the kidneys. It is the leading cause of kidney failure, with nearly one-third of people with diabetes developing this condition. When a person has both diabetes and kidney disease, their overall health outcomes are worse than those with kidney disease alone. This is because people with diabetes often have other long-standing medical conditions, such as high blood pressure, high cholesterol, and blood vessel disease (atherosclerosis).

Symptoms of Diabetic Nephropathy

In the early stages of diabetic nephropathy, there may be no noticeable symptoms. As the condition progresses and kidney function worsens, the following symptoms may appear:

• Swelling of the hands, feet, and face

• Trouble sleeping or concentrating

• Poor appetite

• Nausea

• Weakness

• Itching (end-stage kidney disease) and extremely dry skin

• Drowsiness (end-stage kidney disease)

• Abnormalities in the heart's regular rhythm, due to increased potassium in the blood

• Muscle twitching

As kidney damage progresses, the kidneys become unable to remove waste from the blood, leading to a buildup of toxins in the body. This condition, known as uremia, can cause confusion and even coma.

Diagnosing Diabetic Nephropathy

Diabetic nephropathy can be diagnosed through specific blood tests that look for changes in blood chemistry. Early detection is also possible by finding protein in the urine. It is crucial for people with diabetes to have their urine tested annually, as early intervention can help slow the progression of kidney damage.

Treatment Options for Diabetic Nephropathy

The primary goals of treating diabetic nephropathy are to lower blood pressure and maintain blood sugar control. These steps are essential in slowing the progression of kidney damage. Several medications have been found to be effective in managing diabetic nephropathy:

SGLT2 Inhibitors

SGLT2 inhibitors, such as bexagliflozin (Brenzavvy), dapagliflozin (Farxiga), empagliflozin (Jardiance), and ertugliflozin (Steglatro), help control high blood sugar levels.

ACE Inhibitors

Angiotensin converting enzyme (ACE) inhibitors, including ramipril (Altace), quinapril (Accupril), and lisinopril (Prinivil, Zestril), can slow down the progression of kidney damage. These medications are often prescribed to people with diabetes, even if their blood pressure is normal, to prevent complications.

ARBs

Angiotensin receptor blockers (ARBs) can be used as an alternative to ACE inhibitors if side effects occur.

If left untreated, diabetic nephropathy can lead to advanced kidney failure, requiring treatment with dialysis or a kidney transplant. It is crucial for people with diabetes to work closely with their healthcare provider to monitor their kidney function and manage their condition effectively. By understanding the symptoms, diagnostic methods, and treatment options available, individuals with diabetic nephropathy can take proactive steps to slow the progression of the disease and maintain their overall health.

For more information on diabetic nephropathy and kidney health, visit the National Kidney Foundation website.