Learn About Diabetic Nephropathy

What is the definition of Diabetic Nephropathy?

Kidney disease or kidney damage often occurs over time in people with diabetes. This type of kidney disease is called diabetic nephropathy.

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What are the alternative names for Diabetic Nephropathy?

Diabetic nephropathy; Nephropathy - diabetic; Diabetic glomerulosclerosis; Kimmelstiel-Wilson disease

What are the causes of Diabetic Nephropathy?

Each kidney is made of hundreds of thousands of small units called nephrons. These structures filter your blood, help remove waste from the body, and control fluid balance.

In people with diabetes, the nephrons slowly thicken and become scarred over time. The nephrons begin to leak, and protein (albumin) passes into the urine. This damage can happen years before any symptoms of kidney disease begin.

Kidney damage is more likely if you:

  • Have uncontrolled blood sugar
  • Are obese
  • Have high blood pressure
  • Have type 1 diabetes that began before you were 20 years old
  • Have family members who also have diabetes and kidney problems
  • Smoke
  • Are African American, Mexican American, or Native American
What are the symptoms of Diabetic Nephropathy?

Often, there are no symptoms as the kidney damage starts and slowly gets worse. Kidney damage can begin 5 to 10 years before symptoms start.

People who have more severe and long-term (chronic) kidney disease may have symptoms such as:

  • Fatigue most of the time
  • General ill feeling
  • Headache
  • Irregular heartbeat
  • Nausea and vomiting
  • Poor appetite
  • Swelling of the legs
  • Shortness of breath
  • Itchy skin
  • Easily develop infections
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What are the current treatments for Diabetic Nephropathy?

When kidney damage is caught in its early stages, it can be slowed with treatment. Once larger amounts of protein appear in the urine, kidney damage will slowly get worse.

Follow your provider's advice to keep your condition from getting worse.


Keeping your blood pressure under control (below 140/90 mm Hg) is one of the best ways to slow kidney damage.

  • Your provider will prescribe blood pressure medicines to protect your kidneys from more damage if your microalbumin test is too high on at least two measurements.
  • If your blood pressure is in the normal range and you have microalbuminuria, you may be asked to take blood pressure drugs, but this recommendation is now controversial.


You can also slow kidney damage by controlling your blood sugar level through:

  • Eating healthy foods
  • Getting regular exercise
  • Taking oral or injectable medicines as instructed by your provider
  • Some diabetes medicines are known to prevent the progression of diabetic nephropathy better than other medicines. Talk to your provider about which medicines are best for you.
  • Checking your blood sugar level as often as instructed and keeping a record of your blood sugar numbers so that you know how meals and activities affect your level


  • Contrast dye that is sometimes used with an MRI, CT scan, or other imaging test can cause more damage to your kidneys. Tell the provider who is ordering the test that you have diabetes. Follow instructions about drinking lots of water after the procedure to flush the dye out of your system.
  • Avoid taking an NSAID pain medicine, such as ibuprofen or naproxen. Ask your provider if there is another kind of medicine that you can take instead. NSAIDs can damage the kidneys, more so when you use them every day.
  • Your provider may need to stop or change other medicines that can damage your kidneys.
  • Know the signs of urinary tract infections and get them treated right away.
  • Having a low level of vitamin D may worsen kidney disease. Ask your doctor if you need to take vitamin D supplements.
Who are the top Diabetic Nephropathy Local Doctors?
Highly rated in

UChicago Medicine

UChicago Medicine River East

355 E Grand Ave 
Chicago, IL 60611

George Bakris is an Endocrinologist and a Nephrologist in Chicago, Illinois. Dr. Bakris has been practicing medicine for over 41 years and is rated as an Elite doctor by MediFind in the treatment of Diabetic Nephropathy. He is also highly rated in 16 other conditions, according to our data. His top areas of expertise are Type 2 Diabetes, High Potassium Level, Diabetic Nephropathy, and Renovascular Hypertension. He is licensed to treat patients in Illinois. Dr. Bakris is currently accepting new patients.

Highly rated in

Steno Diabetes Center Copenhagen

Department Of Clinical Medicine 
Copenhagen, DK 

Peter Rossing is in Copenhagen, Denmark. Rossing is rated as an Elite expert by MediFind in the treatment of Diabetic Nephropathy. He is also highly rated in 22 other conditions, according to our data. His top areas of expertise are Diabetic Nephropathy, Type 1 Diabetes, Type 2 Diabetes, and Wilson Disease.

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Highly rated in

University Medical Center Groningen

Groningen, GR, NL 

Hiddo Heerspink is in Groningen, Netherlands. Heerspink is rated as an Elite expert by MediFind in the treatment of Diabetic Nephropathy. They are also highly rated in 15 other conditions, according to our data. Their top areas of expertise are Diabetic Nephropathy, Type 2 Diabetes, Chronic Kidney Disease, and Osmotic Diuresis.

What are the support groups for Diabetic Nephropathy?

Many resources can help you understand more about diabetes. You can also learn ways to manage your kidney disease.

What is the outlook (prognosis) for Diabetic Nephropathy?

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

When should I contact a medical professional for Diabetic Nephropathy?

Call your provider if you have diabetes and you have not had a urine test to check for protein.

Male urinary system
Pancreas and kidneys
Diabetic nephropathy
What are the latest Diabetic Nephropathy Clinical Trials?
A Phase 1, Open-Label Study to Investigate the Dosimetry of Tc-99m-Tilmanocept Following a Single Intravenous Dose Administration in Women and Men Suspected of Diabetic Nephropathy.
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China Kidney Patient Trials Network
What are the Latest Advances for Diabetic Nephropathy?
Efficacy and safety of Zicuiyin decoction on diabetic kidney disease: A multicenter, randomized controlled trial.
Comparative efficacy of seven Chinese patent medicines for early diabetic kidney disease: A Bayesian network meta-analysis.
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Targeting Inflammation in Diabetic Kidney Disease: Is There a Role for Pentoxifylline?
Who are the sources who wrote this article ?

Published Date : January 26, 2020
Published By : Brent Wisse, MD, board certified in Metabolism/Endocrinology, Seattle, WA. Internal review and update on 06/03/2021 by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

What are the references for this article ?

American Diabetes Association. 11. Microvascular Complications and Foot Care: Standards of Medical Care in Diabetes-2021. Diabetes Care. 2021 Jan;44(Suppl 1):S151-S167. PMID: 33298422 pubmed.ncbi.nlm.nih.gov/33298422/.

Brownlee M, Aiello LP, Sun JK, et al. Complications of diabetes mellitus. In: Melmed S, Auchus, RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. Williams Textbook of Endocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020:chap 37.

Tong LL, Adler S, Wanner C. Prevention and treatment of diabetic kidney disease. In: Feehally J, Floege J, Tonelli M, Johnson RJ, eds. Comprehensive Clinical Nephrology. 6th ed. Philadelphia, PA: Elsevier; 2019:chap 31.