For health professionals 
Diabetic nephropathy is a kidney disease that occurs in people with type 1 or type 2 diabetes. Up to 50% of people living with diabetes will eventually experience kidney damage, and they risk kidney failure without proper treatment. Fortunately, good diabetes management and effective prevention can delay or even prevent the loss of kidney function.
The kidneys are two fist-sized organs located near the back, below the rib cage. Their job is to filter blood and eliminate waste through urine. They also regulate the amount of fluid and salt in the body, which is an essential part of controlling blood pressure.
Diabetes is the leading cause of kidney disease and failure in Canada. Over time, hyperglycemia and hypertension come to damage the tiny vessels in the kidneys that filter blood. Normally, when the kidneys filter blood, they reabsorb protein. But, if they're injured, protein can pass through and enter the urine. “Microalbuminuria” occurs when small amounts of albumin are found in urine, and “proteinuria” occurs when the amounts are larger. Basically, the body gets rid of useful proteins while keeping in waste and excess products. Kidneys then have to work harder to fulfill their role, which tires them out and can lead to kidney failure.
Often, no one will notice anything wrong before kidneys start failing, which is why it’s so important to get tested regularly. However, there are some symptoms that can indicate a problem, including loss of sleep or appetite, stomach pains, weakness, difficulty concentrating, tiredness, swelling in the eyelids, hands or feet, vomiting or generalized itching.
Long-standing diabetes is one of the main risk factors alongside genetics, hyperglycemia, high blood pressure, obesity and smoking, among others.
To prevent this condition, it’s essential that you maintain a healthy lifestyle as recommended by your healthcare professional. Try to keep your blood sugar, blood pressure and cholesterol levels within optimal ranges. Limit your alcohol intake as much as possible and if you smoke, consider quitting. Eat healthy and exercise regularly.
A urine and blood test analyzed in a laboratory can measure the presence of albumin and thus check on the condition of your kidneys. People living with type 1 diabetes should undergo testing five years after their diagnosis and then once a year afterwards. As for people living with type 2 diabetes, they should be tested when they receive their diagnosis and once a year thereafter.
If nephropathy is diagnosed in its early stages, your healthcare professional may design a treatment plan that combines lifestyle changes and medication (blood glucose and blood pressure control, exercise, medication to prevent kidney damage, quitting smoking and drinking, a healthy diet low in sodium and protein, etc.).
However, if nephropathy is too advanced, or if the initial treatment fails, dialysis or a kidney transplant may be necessary.
As you probably guessed, prevention is key. Take good care of your kidneys and they’ll take care of you!
References:
Canadian Diabetes Association (n.d), Kidney Disease. Retrieved from: https://www.diabetes.ca/diabetes-and-you/complications/kidney-disease. Accessed August 10 2020.
Diabetes Québec (2014). Nephropathy. Retrieved from: http://www.diabete.qc.ca/en/understand-diabetes/all-about-diabetes/complications/nephropathy/. Accessed August 10 2020.
National Institute of Diabetes and Digestive and Kidney Diseases (2017). Diabetic Kidney Disease. Retrieved from: https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/diabetic-kidney-disease. Accessed August 10 2020.
WebMD (2019). Diabetic Nephropathy. Retrieved from: https://www.webmd.com/diabetes/guide/diabetes-kidney-disease. Accessed August 10 2020.