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What is Nephropathy?

Diabetes can cause damage to the kidneys, which is known as renal disease or nephropathy.

About 20-25 per cent of people with diabetes may develop nephropathy, although this number is steadily declining. If detected early the condition can be treated successfully in many cases.

Symptoms
Diagnosis
What causes nephropathy?
Treatment

Symptoms

There are no obvious symptoms of nephropathy in the early stages which is why regular testing for the condition is important. If left untreated the body will lose a great deal of protein in the urine.

This may cause the urine to froth and lead to a build up of fluid in the body (water retention or oedema), especially around the ankles. Eventually the condition may result in end stage renal failure, where the kidneys are unable to remove waste products from the body and the person will need dialysis or a transplant.

Diagnosis

The earliest stages of nephropathy can be tested by a urine test. Often a dipstick test will show if there is any protein present. Many clinics now test for microalbumin, tiny particles of protein, which are a good indicator that a problem is developing.

If detected early, nephropathy can often be successfully treated. In some cases a 24 hour urine test may be required, to see how much protein is being lost, or the doctor might ask for a specimen of the first urine passed in the morning. Urine should be tested for protein at least once a year. A positive test does not mean you have nephropathy as other conditions such as infections can also lead to protein in the urine. A second test should be carried out to confirm diagnosis.

What causes nephropathy?

Nephropathy is caused by damage to the tiny blood vessels which supply the kidneys. The walls of these blood vessels in the kidneys become thickened or irregular and this means that they are unable to filter waste products out of the blood into the urine properly.

Treatment

If detected early enough, successful treatments can be given. These involve dietary changes, restricting the amount of protein in the diet, and controlling high blood pressure, which can worsen the problem.

A group of drugs called ACE inhibitors have also been used to protect the kidneys from further damage. They are normally prescribed for high blood pressure but can be given even if blood pressure is normal.

If nephropathy worsens, dialysis may be necessary, which can be carried out at home or in a clinic. In the very worst scenario a kidney transplant may be required. If either of these treatments is needed, you will be seen by a specialist renal team of doctors and nurses, who will be able to give information and support.

And finally...

The most important thing to remember is to make sure you have your urine tested for protein at least once a year. If detected early, nephropathy can usually be well managed.

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