What is diabetic nephropathy?
Nephropathy is the deterioration of the kidneys. The final stage of nephropathy is called end-stage renal disease, or ESRD.

Diabetes is the most common cause of ESRD, accounting for more than 40 percent of cases. About 16 million people in the US have diabetes, and about 50,000 people have ESRD as a result of diabetes. Both type 1 and type 2 diabetes can lead to diabetic nephropathy, although type 1 is more likely to lead to ESRD.

There are five stages of diabetic nephropathy, or deterioration of the kidneys. The fifth stage is ESRD. Progress from one stage to the next can take many years, with 23 years being the average length of time to reach stage five.

What causes diabetic nephropathy?
Hypertension, or high blood pressure, is a complication of diabetes that is believed to contribute most directly to diabetic nephropathy.

Hypertension is believed to be both the cause of diabetic nephropathy, as well as the result of damage that is created by the disease. As kidney disease progresses, physical changes in the kidneys often lead to increased blood pressure.

Uncontrolled hypertension can make the progress toward stage five diabetic nephropathy occur more rapidly.

Can diabetic nephropathy be prevented?
The onset and progression of diabetic nephropathy can be slowed by intensive management of diabetes and its symptoms, including taking medications to lower blood pressure.

Treatment for diabetic nephropathy:
Specific treatment will be determined by your physician(s) based on:

• your age, overall health, and medical history
• extent of the disease
• your tolerance for specific medications, procedures, or therapies
• expectations for the course of the disease
• your opinion or preference

Treatment may include any, or a combination of, the following:

• proper diet
• exercise
• strict monitoring and controlling of blood glucose levels, often with medication and insulin injections
• medication (to lower blood pressure)

Treatment for ESRD often initially includes dialysis to cleanse the blood, and eventually, kidney transplantation.

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