Diabetic kidney disease, or diabetic nephropathy, is a complication of type 1 or type 2 diabetes caused by damage to the kidneys' delicate filtering system.
Your kidneys contain millions of tiny blood vessel clusters (glomeruli) that filter waste from your blood. Severe damage to these blood vessels can lead to diabetic nephropathy, which may lead to kidney failure or irreversible end-stage kidney disease, requiring dialysis or a kidney transplant.
If you have diabetic nephropathy, it's very important for you to have your kidney function tested and monitored to prevent it from worsening and reduce your risk of heart disease.
If you have additional conditions — such as high cholesterol, high blood pressure or anemia — or you're obese or you smoke, your risk of diabetic nephropathy increases even more.
- Experience and expertise. Mayo Clinic doctors have significant expertise and experience, treating more than 2,500 people with diabetic nephropathy each year.
- Team approach. Your multispecialty team may include experts from nephrology, hypertension, endocrinology and other areas. In Minnesota, Mayo Clinic's Chronic Kidney Disease Clinic provides comprehensive care, including a therapy plan tailored to your needs.
- Newest research. Mayo researchers in the Division of Nephrology and Hypertension work together both nationally and internationally on clinical trials to help develop new treatments and understand the underlying causes of diabetic nephropathy. They also serve on the Mayo Nephrology Collaborative Group, a national network for clinical research on kidney disease.
Mayo Clinic in Rochester, Minn., ranks No. 1 for kidney disorders in the U.S. News & World Report Best Hospitals rankings. Mayo Clinic in Scottsdale, Ariz., ranks among the Best Hospitals for kidney disorders by U.S. News & World Report. Mayo Clinic in Jacksonville, Fla., is ranked high performing for kidney disorders by U.S. News & World Report.
Mayo Clinic uses several diagnostic tests to identify diabetic nephropathy and other kidney problems. These include:
- Blood tests. You will need blood tests to monitor your diabetes and determine how well your kidneys are working.
- Urinalysis. Urine samples provide information about your kidney function and whether there are high levels of a protein called microalbumin in your urine.
- Renal imaging. Specialists may use ultrasound and magnetic resonance imaging (MRI) to determine how well blood is circulating within your kidneys. X-rays may be used to detect whether your kidneys have structural abnormalities.
- Renal function testing. Doctors can assess your kidneys' filtering capacity using renal analysis testing. Mayo Clinic offers exceptionally precise measurement of the glomerular filtration rate — a very accurate measure of overall renal function.
- Kidney biopsy. Doctors may want to examine your kidney tissue. For this procedure, a needle is used to extract small pieces of kidney tissue for examination under a microscope.
Read more about urinalysis, ultrasound, MRI and kidney biopsy.
Treatment for diabetic nephropathy at Mayo Clinic focuses on slowing its progression and managing your high blood pressure (hypertension) and protein in your urine (proteinuria). This usually involves the joint efforts of a multidisciplinary team that may include your nephrologist, endocrinologist and dietitian.
You'll receive a customized treatment plan, which may include:
- Management of proteinuria. Medications can often reduce the level of albumin, a protein, and improve kidney function.
- High blood pressure management. Medications, diet and physical activity can help control high blood pressure.
- Blood sugar control. Medications, diet and physical activity can help control your blood sugar levels.
- Medication review. Nephrologists and nurse specialists will review your current medications and adjust dosages or change medications if necessary.
- Preventive measures for complications from contrast dye studies. You'll receive information about your risks of increased kidney damage from medical tests that involve the use of contrast dye.
- Customized dietary plan. Dietitians can provide you with a personalized dietary plan and nutrition advice, including ways to limit salt, protein, caffeine and alcohol.
- Cholesterol control. You'll be advised on diet, physical activity and medications to help control cholesterol levels.
- Treatment of anemia. You'll be assessed for a low red blood cell count (anemia) and receive medication if necessary.
- Bone health. Diet and medications may help manage your calcium phosphate balance, which is important in maintaining healthy bones.
- Anti-platelet therapy. Your doctor may prescribe a low dose of daily aspirin to prevent blood clots, unless you can't take daily aspirin because of side effects.
- Other lifestyle changes. Team members can provide information on how to make other healthy lifestyle changes, such as a smoking cessation program, exercise programs and weight management suggestions.
If you have end-stage kidney disease, treatment may include:
- Dialysis. Mayo Clinic offers state-of-the-art dialysis treatment, including the option for in-home dialysis.
- Kidney transplant. The Mayo Clinic kidney transplant program offers pre-transplant consultation, living donor evaluation, kidney transplantation and post-transplantation care.
Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people. In most cases, Mayo Clinic doesn't require a physician referral. Some insurers require referrals or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.
At Mayo Clinic in Arizona, specialists in nephrology and hypertension and other experts, if needed, treat diabetic nephropathy.
For appointments or more information, call the Central Appointment Office at 800-446-2279 (toll-free) 8 a.m. to 5 p.m. Mountain Standard Time, Monday through Friday or complete an online appointment request form.
- U.S. Patients
- International Patients
At Mayo Clinic in Florida, specialists in nephrology and hypertension and other experts, if needed, treat diabetic nephropathy.
For appointments or more information, call the Central Appointment Office at 904-953-0853 8 a.m. to 5 p.m. Eastern time, Monday through Friday or complete an online appointment request form.
- U.S. Patients
- International Patients
At Mayo Clinic in Minnesota, people with diabetic nephropathy are treated in the Chronic Kidney Disease Clinic. A team of nephrologists, hypertension nurses and dietitians develops a specialized treatment plan to customize your therapy.
For appointments or more information, call the Central Appointment Office at 507-538-3270 7 a.m. to 6 p.m. Central time, Monday through Friday or complete an online appointment request form.
- U.S. Patients
- International Patients
See information on patient services at the three Mayo Clinic locations, including transportation options and lodging.
Research at Mayo Clinic in diabetic nephropathy includes developing new diagnostic and treatment tools, such as oral drugs that may help stop or delay the decline of kidney function and possibly improve it.
See a list of publications by Mayo Clinic doctors on diabetic nephropathy on PubMed, a service of the National Library of Medicine.
May 28, 2014
- Alpern RJ, et al. Seldin and Giebisch's The Kidney. 5th ed. Philadelphia, Pa.: Elsevier; 2013. http://www.clinicalkey.com. Accessed Feb. 17, 2014.
- Kidney disease and diabetes. American Heart Association. http://www.heart.org/HEARTORG/Conditions/Diabetes/WhyDiabetesMatters/Kidney-Disease-Diabetes_UCM_313867_Article.jsp. Accessed Feb. 17, 2014.
- Kidney disease (nephropathy). American Diabetes Association. http://www.diabetes.org/living-with-diabetes/complications/kidney-disease-nephropathy.html. Accessed Feb. 17, 2014.
- Taal MW, et al. Brenner and Rector's The Kidney. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2011. http://www.clinicalkey.com. Accessed Feb. 17, 2014.
- Fatehi P, et al. Diagnostic approach to the patient with acute kidney injury (acute renal failure) or chronic kidney disease. http://www.uptodate.com/home. Accessed Feb. 17, 2014.
- Riggin EA. Decision Support System. Mayo Clinic, Rochester, Minn. Feb. 17, 2014.