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Diabetic nephropathy (kidney disease)

Diabetic nephropathy is the name given to kidney damage caused by diabetes. It develops slowly, over many years, and is also referred to as kidney disease.

Almost one in five people with diabetes will need treatment for diabetic nephropathy. This may be a worrying statistic, but there’s a lot you can do to reduce your risk of developing the complication. If spotted early enough, diabetic nephropathy can also be slowed down with treatment.

That's why it's so important to get your kidney checks as part of your annual review every year.

What causes kidney disease?

One of the main jobs of your kidneys is to filter your blood. They get rid of extra fluid and waste products from your body through your urine.

High blood glucose (sugar) levels can damage the small blood vessels and tiny filters in your kidneys. High blood pressure can also do this too. This can cause them to leak and not work as well. When this happens, abnormal amounts of protein from the blood can leave your body in your urine. This is often an early sign of kidney disease.

Diabetic nephropathy (kidney disease) infographic showing a healthy kidney filtering out waste to the urine and sending protein back into the bloodstream
Diabetic nephropathy (kidney disease) infographic showing abnormal amounts of protein are leaving the body through the urine. This is an early sign of kidney disease.

Symptoms of kidney disease

You may not have visible symptoms in the early stages of kidney disease. This is why it's so important to have the tests for kidney disease every year, as it can be spotted early and slowed down with treatment. If kidney disease progresses, you could notice symptoms like:

  • swollen ankles, feet and hands
  • blood in your pee (urine)
  • feeling really tired
  • being short of breath
  • feeling sick.

You may be feeling like this because your kidneys are struggling to clear extra fluid and waste from your body. But these symptoms can also be caused by other conditions, so it’s important to talk to your doctor for more information and advice.

How can I reduce my risk of kidney disease?

There are lots of things you can do to reduce your risk of developing kidney disease:

  • Keep your blood sugar (glucose) levels within your target range 
  • Keep your blood pressure down
  • Get support to stop smoking
  • Eat healthily and keep active
  • Go to all your medical appointments.

We have lots of information and support to help you – have you tried our Learning Zone? Thousands of people with diabetes are using it to help them manage their diabetes. You can also download a copy of our 'Diabetes and kidney disease' leaflet free of charge from our online shop. 

Tests for kidney disease

The two tests for kidney disease are included in your annual review. You should normally have these tests every year.

Urine test (ACR)

A simple urine test called the albumin: creatinine ratio (ACR) looks for signs that protein is leaking into the urine. This is often an early sign of kidney disease.

This test is one people often miss out out on because they may not find it easy to provide a sample of their wee. Read our tips on providing a urine sample on our diabetes health checks page.

Blood test (eGFR)

It tests for a waste product called creatinine. Your creatinine level and other information (such as age, sex and ethnicity) are used to estimate your glomerular filtration rate (eGFR). This is a measure of how well your kidneys are working.

It may take around a week to receive your test results. And you might need to have further tests. If you want more information whilst you wait, call our helpline and speak to one of our advisors for answers and support. 

Some people are being sent, by their  healthcare team, a home-based test that allows you to measure your albumin and creatinine concentrations in a sample of your urine, and your albumin-to-creatinine ratio (ACR). To do the test, you'll need the testing kit that's been designed to use with the app and need to pre-register using a unique link sent by your team.

The app guides you step-by-step through the testing process. You put a dipstick into your urine and take a photo of it using your smartphone. Computer vision algorithms are used to analyse the sample and give an accurate reading. After the analysis, the results are automatically sent to your patient electronic record so they can be reviewed by your doctor.

You can find out more on the NHS website.

Your GP may also give you an Information Prescription, developed by us, which can help you understand your test results and develop an action plan. 

Treating kidney disease

The type of treatment you need will depend on the stage of kidney disease. 

It’s very important to keep your blood pressure under control to stop kidney disease from getting worse. You may be given tablets, such as ACE inhibitors or ARBs, to help with this. 

Both ACE inhibitors and ARBs help to protect the kidneys from further damage, as well as lower blood pressure. That’s why they are also made available to people without high blood pressure. 

You may also get advice to avoid certain foods, but you’ll need to get support from a registered dietitian to help you with the changes to your diet. 

If you do develop late-stage kidney disease and your kidneys fail, your treatment options include dialysis or a kidney transplant. The good news is, as treatments and early diagnosis continues to improve, fewer people will go on to develop late-stage kidney disease. 

More information and support about kidney disease

Talk with your diabetes team. They should be able to answer most of your questions. And we’re here to provide support and information when you need it too. 

If you have more questions, or just want someone to listen, give our helpline a call. You’ll be able to talk things through with highly trained advisors who have counselling skills and an extensive knowledge of diabetes. 

The National Kidney Federation have kidney disease leaflets and can put you in touch with a local group. Kidney Care UK also offers resources and support including a telephone counselling service that you may find useful.

Kidney Research UK are dedicated to research into kidney disease. We’ve been working together to identify the most important areas of future research, so that we can ultimately stop kidney disease in people with diabetes.

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