Diabetic Nephropathy



Blood passes through small filters in the kidneys. Changes in the blood vessels due to diabetes can cause damage to these filters. This can make it hard for them to clean the blood properly and cause protein from the blood to leak into the urine. If left untreated, this can lead to kidney failure.

Risk Factors

Things that may raise the risk of this problem are Type 1 diabetes and Type 2 diabetes with:

  • Poor control of blood glucose levels
  • High blood pressure—puts more stress on the kidneys and increases the risk of kidney damage
  • High cholesterol



Symptoms may not appear until kidney damage is severe. A person may have:

  • Weakness
  • Lack of hunger
  • Nausea and vomiting
  • Swelling in the feet or hands
  • Problems sleeping
  • Confusion and trouble with focus


The doctor will ask about symptoms and health history. A physical exam will be done.

Blood tests will be done to check kidney function. Urine tests will be done to look for protein, which is an early sign of kidney damage.

If the diagnosis is not clear, a kidney biopsy may be done to check for damage.



The goal of treatment is to prevent or slow damage. Diabetes and blood pressure will both need to be controlled. Treatment options are:

Lifestyle Changes

Lifestyle changes that will help control blood sugar and blood pressure are:

  • Reaching or keeping a healthy weight
  • Working out regularly
  • Limiting salt and protein
  • Not smoking
  • Avoiding alcohol


Medicine may be given to:

  • Help control diabetes
  • Reduce protein in the urine
  • Protect the kidneys
  • Treat high blood pressure

Treatments for Kidney Failure

Dialysis may be needed for those with kidney failure. Dialysis takes over the job of the kidneys. Blood passes out of the body into a machine. The machine filters waste out of the blood, and then pumps blood back to the body.

If the kidney failure gets worse, a kidney transplant may be needed.


People with diabetes and high blood pressure can lower the risk of this problem by following their care plan.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Edits to original content made by Denver Health.