Diabetic Nephropathy

Treatment Options

Treatment of diabetic nephropathy (diabetic kidney disease) is directed at slowing the progression of the disease and managing accompanying high blood pressure (hypertension) and protein excretion in urine (proteinuria).

Every patient with diabetic kidney disease seen at Mayo Clinic receives a specialized treatment plan developed at Mayo to monitor blood pressure and kidney function as well as adjust medication therapy when appropriate.

This treatment plan includes:

• Management of urinary protein excretion — medications are used to reduce the level of the protein albumin and improve kidney function.
• Hypertension management — medications are used to control the patient's blood pressure
• Blood sugar control — medications are used to control the level of blood sugar and manage the patient's diabetes.
• Specialized dietary plan — dietitians provide patients with a personalized dietary plan and nutrition education on ways to limit consumption of salt, protein, caffeine and alcohol
• Antiplatelet therapy — low dose aspirin is prescribed if indicated
• Lifestyle modifications — nephrology nurse specialists counsel patients to help them make important lifestyle changes to maintain good health. Patients learn about smoking cessation treatment, exercise programs and weight management.
• Medication review — nephrologists and nurse specialists review current medications taken by each patient and help to adjust dosage or change medication if necessary. Patients are counseled about medications that should be avoided to prevent further kidney damage such as non-steroidal anti-inflammatory medications.
• Preventive measures for complications from contrast dye studies — patients with diabetic nephropathy are at risk for increased kidney damage from medical tests that involve the use of contrast dye. Nephrologists and nurses work together to ensure these risks are minimized and to educate patients on ways to avoid further kidney damage when participating in these tests.
• Cholesterol control — lifestyle modifications, diet and medications are used to control cholesterol levels
• Treatment of anemia — anemia is assessed and treated with medications if necessary
• Calcium phosphate — diet and medications are used to manage the calcium phosphate balance

Additional novel therapies being tested in clinical trials through the Diabetic Nephropathy Clinic in Minnesota are available for eligible patients.

For those patients who progress to end stage kidney disease, treatment may include:

• Dialysis — Mayo Clinic offers state-of-the-art dialysis treatment including the option for in-home dialysis. Dialyis services are available at Mayo Clinic in Arizona, Florida, and Minnesota.
• Kidney transplant — the Mayo Clinic Kidney Transplant Program offers pre-transplant consultation, living donor evaluation, kidney transplantation and post transplantation care.