Description Diabetic nephropathy means kidney damage caused by diabetes. High blood s...
Description
Diabetic nephropathy means kidney damage caused by diabetes. High blood sugar levels (hyperglycemia) for long periods of time and uncontrolled high blood pressure make it progress more rapidly. The elevated blood sugar and blood pressure cause injury to small blood vessels in the kidneys. As the kidneys become damaged they are unable to remove waste products from the blood. Over time the kidneys can completely fail requiring the patient to need dialysis or a kidney transplant. The likelihood of having this disorder increases with age and with the length of time someone has diabetes. This condition may occur in both Type I and Type II diabetics. Patients with this disorder do not begin having symptoms until a majority of the kidney function is lost. This is why it is important for diabetic patients to have regular checks of their blood sugar and blood pressure and keep them under good control.
Symptoms
Symptoms may vary depending on the severity of the condition. Early symptoms may include ankle swelling and fatigue. Later symptoms may include decreased urination, fatigue, loss of appetite, nausea and vomiting.
Tests
Common tests used for diagnosis and treatment
Workup:
A complete history and physical will be performed. Blood and urine tests will be done to measure the kidney function. A BUN (blood urea nitrogen) and a creatinine are the most common blood tests performed to measure kidney function. These tests are part of a complete metabolic panel (CMP). An ultrasound of the kidneys may also be performed to measure the size and/or blood flow to the kidneys.
Tests:
Complete blood count (CBC), Comprehensive metabolic panel (CMP), Urinalysis (UA)
Other Specific Tests: kidney biopsy, 24-hour urine protein
Specialists:
Internal Medicine, Pediatrics, Nephrology, Family Practice, Diabetes, Endocrinology and Metabolism, Pediatric Endocrinology, Pediatric Nephrology
Workup:
A complete history and physical will be performed. Blood and urine tests will be done to measure the kidney function. A BUN (blood urea nitrogen) and a creatinine are the most common blood tests performed to measure kidney function. These tests are part of a complete metabolic panel (CMP). An ultrasound of the kidneys may also be performed to measure the size and/or blood flow to the kidneys.
Tests:
Complete blood count (CBC), Comprehensive metabolic panel (CMP), Urinalysis (UA)
Other Specific Tests: kidney biopsy, 24-hour urine protein
Specialists:
Internal Medicine, Pediatrics, Nephrology, Family Practice, Diabetes, Endocrinology and Metabolism, Pediatric Endocrinology, Pediatric Nephrology
Treatment
Choice of treatment is based on the progression of the disease. Blood glucose levels should be controlled to prevent further progression of the disease. Management of coexisting high blood pressure using a combination of diet (low sodium diet), exercise and medication is essential to slowing the progression of the disease. Goal blood pressure is less than 140/90 but many doctors strive for less than 130/80 mm Hg to prevent further kidney injury. End stage renal disease (ERSD) occurs when most of the kidney function is gone. Patients with ESRD may require dialysis or kidney transplantation.