Diabetic Nephropathy
Diabetic nephropathy is chronic kidney disease attributed to diabetes, usually developing through albumin leakage, declining filtration or both.
Key points
- Annual urine albumin-to-creatinine ratio and estimated filtration can detect injury before symptoms appear.
- Blood-pressure treatment, SGLT2 inhibitors and renin–angiotensin system blockade have kidney-protective roles in appropriate patients.
- Sudden kidney decline, active urine sediment or atypical timing suggests another or additional kidney disease.
The listings below are not a universal kidney regimen; potassium, filtration, albuminuria, blood pressure and diabetes type affect selection.
Confirming persistent kidney damage
Albuminuria is repeated because exercise, fever, infection and marked hyperglycaemia can transiently raise it. eGFR trend matters more than one result. Clinicians review retinopathy, duration of diabetes, urine microscopy and imaging when features are atypical.
Protecting kidney and cardiovascular function
ACE inhibitors or ARBs reduce albuminuria in appropriate hypertensive patients but need creatinine and potassium monitoring. SGLT2 inhibitors can slow kidney decline across specified filtration ranges and require sick-day guidance. Glucose, smoking, lipids and dietary sodium are addressed without causing hypoglycaemia or malnutrition.
When to seek urgent care
Seek urgent care for severe breathlessness, confusion, very low urine output, rapidly worsening swelling, persistent vomiting, chest pain or symptoms of dangerously high potassium such as marked weakness or palpitations.