A kidney biopsy confirms the diagnosis. However, your doctor can often diagnose the condition without a biopsy. A biopsy is done if there is any doubt about the diagnosis.
The goal of treatment is to keep the kidney disease from getting worse. Keeping your blood pressure under control (under 130/80) is one of the best ways to slow kidney damage.
Your doctor may prescribe medicines to lower your blood pressure and protect your kidneys from more damage. Often, the best types of medicine to use are ACE inhibitors and angiotensin receptor blockers (ARBs).
Eating a low-fat diet, taking drugs to control lipids, and getting regular exercise can also help prevent or slow kidney damage.
To help slow kidney damage, closely control your blood sugar levels by:
Diabetic kidney disease is a major cause of sickness and death in people with diabetes.
When it is caught in the early stages, kidney damage may be slowed with treatment. Once larger amounts of protein appear in the urine, kidney damage will slowly get worse. Often, it will lead to the need for dialysis or a kidney transplant.
People with diabetic kidney disease often also have problems with high blood pressure, heart disease, and eye damage.
Calling your health care provider
Call your health care provider if you have diabetes and you have not had a routine urinalysis to check for protein.
Before having an MRI, CT scan, or other imaging test where you may receive a contrast dye that contains iodine, tell your doctor. These dyes can further damage the kidneys.
Commonly used pain medicines, such as ibuprofen, naproxen, and prescription COX-2 inhibitors such as celecoxib (Celebrex) may injure the weakened kidney. Always talk to your health care provider before using any of these drugs.
American Diabetes Association. Standards of medical care in diabetes--2011. Diabetes Care. 2011 Jan;34 Suppl 1:S11-61.
Inzucchi SE, Sherwin RS. Diabetes Mellitus. In: Goldman L, Ausiello D, eds. Cecil Textbook of Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 248.
American Diabetes Association (2004). Nephropathy in diabetes. Clinical Practice Recommendations 2004. Diabetes Care. 27(Suppl 1): S79ï¿½S83.
Parving H, Mauer M, Ritz E. Diabetic Nephropathy. In: Brenner BM. Brenner and Rector's The Kidney. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 36.
A.D.A.M. Editorial: David Zieve, MD, MHA, and David R. Eltz. Previously reviewed by Ari S. Eckman, MD, Chief, Division of Endocrinology, Diabetes and Metabolism, Trinitas Regional Medical Center, Elizabeth, NJ. Review provided by VeriMed Healthcare Network (6/28/2011).