What is diabetic nephropathy?

Diabetes canaffect many parts of the body, including the kidneys. In healthy kidneys, manytiny blood vessels filter waste products from your body. The blood vessels haveholes that are big enough to allow tiny waste products to pass through into theurine but are still small enough to keep useful products (such as protein andred blood cells) in the blood. High levels of sugar in the blood can damagethese vessels if diabetes is not controlled. This can cause kidney disease,which is also called nephropathy (say: nef-rah-puh-thee). If the damage is badenough, your kidneys could stop working.

What are the symptoms of diabetic nephropathy?

Diabetic nephropathy does not usually cause any symptoms until kidney damage is severe. As the condition progresses, symptoms can include the following:

• Swelling of the feet and ankles
• Weakness
• Loss of appetite
• Upset stomach
• Insomnia and difficulty sleeping
• Confusion and trouble concentrating

How is diabetic nephropathy diagnosed?

Your doctor will test your urine for protein. If there is protein in your urine, this could mean that your diabetes has damaged the holes in the blood vessels of your kidneys. This makes the holes big enough for protein and other nutrients your body needs to leak into your urine. Your doctor may also want to do a blood test to see how much damage has been done to the kidneys.

What can I do to slow down the damage?

The following are some of the most important things you can do to protect your kidneys:

• Keep your blood pressure lower than 130 over 80. High blood pressure can speed up damage to the kidneys. Your doctor may give you medicine to help lower your blood pressure.
• Control your blood sugar level. You should take your diabetes medicines and/or insulin exactly as your doctor prescribes.
• Stick to a healthy diet. People who have diabetic nephropathy may need to eat less protein.
• Be physically active every day.
• Stop smoking.
• Check with your doctor before taking any new medicines. This includes vitamins, herbal medicines and over-the-counter medicines.
• Keep all of your doctor appointments.

What happens if my kidneys stop working?

Even with the right treatments, diabetic nephropathy can get worse over time. Your kidneys could stop working. This is called kidney failure. If this happens, waste products build up in your body. This can cause nausea, vomiting, weakness, shortness of breath and confusion. In severe cases, kidney failure can cause seizures and coma.

If you have kidney failure, your doctor will refer you for dialysis (say: die-al-uh-sis). In dialysis, a machine is used to take waste products out of the blood. One kind of dialysis has to be done in a clinic. For another kind of dialysis, the machine is so small it can be strapped to your body while you go about your daily activities. If you develop kidney failure, your doctor will help you decide which type of dialysis machine is right for you.

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