Officially known as diabetic nephropathy, nephropathy is a type of kidney disease that leads to kidney failure. Nephropathy tends to develop in people who have had diabetes for 20 years or more. It used to be that a third of all people with type 1 diabetes developed nephropathy, but today's treatment methods and the emphasis on better blood-sugar control are shrinking that percentage. People with type 2 diabetes develop nephropathy infrequently.
How It Happens
To see why nephropathy would be a problem, let's look first at what the kidneys do. The kidneys are organs located near the waist. Inside the kidneys are small blood vessels, called glomeruli, that act as filters, removing wastes from the blood and discharging them through the urine. Useful products, such as protein and glucose, are not eliminated but are sent back into the bloodstream.
Nephropathy is the condition in which small arteries in the kidneys become hardened and the glomeruli become damaged, in much the same way that the small vessels of the eye become damaged during retinopathy. The kidneys ultimately fail in their job of filtering out wastes. People with kidney failure must go on dialysis (the use of a machine to filter blood) or have a kidney transplant; otherwise, lethal levels of wastes and toxins build up in their bodies.
Nephropathy is caused by high blood-sugar levels. Also, high blood pressure, arteriosclerosis, smoking, and high cholesterol increase the likelihood of kidney complications. Frequent urinary tract infections add to the problem because an infection can easily spread to the kidneys and damage them.
Recognizing the Signs
Early warning signs of nephropathy include problems emptying the bladder, blood in the urine, and urinary tract infections. The disease can be confirmed through simple urine and blood tests. Just as the kidneys lose their ability to discharge wastes, they also lose their ability to keep protein and glucose in circulation. Sugar and protein begin to show up in the urine tests in larger and larger amounts. Blood tests also detect high levels of urea nitrogen and creatinine, another indication of kidney damage.
Handling the Problem
To halt kidney damage before kidney failure occurs, the wisest step is to take urinary tract infections seriously. Remember: Infections can back up further into the urinary system and spread to the kidneys, impairing their function.If signs of developing kidney problems are detected, doctors often recommend a regimen of tight blood-sugar control and a low-protein diet to ease stress on the kidneys. Recent clinical studies suggest that use of the blood-pressure lowering drugs like enalapril may preserve kidney function.
