Diabetic Nephropathy
Dr. Leonel Porta
Written by Dr. Leonel Porta

Diabetic Nephropathy is nothing other than the kidney damage that occurs as the result of diabetes. It is estimated that nearly 30% of people with diabetes mellitus (Type 1 or Type 2 Diabetes) develop the disease in their lifetime. Kidney failure from diabetes develops so slowly that the patient may feel no symptoms for many years. Hence, the importance of knowing that the origin of this complication would allow to take the best measures to prevent it.

The main function of the kidneys is to filter the blood, removing waste products from the body and control the fluid balance, so that the body retains the nutrients and get rid of the waste materials. Filtration takes place through a compact tiny cluster of capillaries called Glomeruli. In healthy kidneys, the Glomeruli filter the blood to remove waste materials then reabsorb the proteins into the blood. Albumin is the most important reabsorbed protein. It is synthesized in the liver and is the main protein in blood. Once the blood is filtered, albumin leaves the kidney and goes back into the bloodstream.

What happens in Diabetics? High levels of blood sugar and High Blood Pressure will eventually damage the Glomeruli. When that happens, the glomeruli are not able to successfully carry out their function of filtration. At first, the Glomeruli filtering membrane becomes altered and gradually subtle amounts of albumin are excreted through the urine. This is called Microalbuminuria, which is an early sign of Diabetic Kidney Disease. During this period the kidney filtration function might seem normal.

If this complication is not properly treated, more albumin leaks into the urine and large amounts of protein are lost. This is known as Pacroalbuminuria or Proteinuria. As the amount of albumin in the urine increases, the filtration functions of the kidneys become more impaired and the body cannot efficiently eliminate waste compounds derived from the normal metabolism. This damage to the kidneys can take place years before any symptom can be clinically detected.

As you can see, the human body does not always show early signs of certain diseases. Diabetic Nephropathy takes years to develop and it is likely that you will not notice any symptom until years later. Moreover, it has been shown in some diabetics that kidney filtration works even better than normal during the first years of diabetes.

The best way to lower the risk of Nephropathy is to visit your physician on a regular basis so an assessment of the kidney function can be carried out. Also, it is crucial to follow the appropriate treatment for controlling the levels of blood sugar. On the other hand, if you suffer from other diseases, your doctor may need to suspend some of the medications to avoid additional damage to your kidneys.

Diabetic Nephropathy is a major cause of illness and death in people with diabetes and it must not be neglected in any way. Remember that it can lead to a severe renal insufficiency where the resolution might require Dialysis or a Kidney Transplant.


About the author

Dr. Leonel Porta

Dr. Leonel Porta

Medical doctor and author of several publications. He has developed experience as a general practitioner and occupational health care, continually facing diabetes. His medical training and Jesuit values enable Leonel’s articles to seek not only physical, but also psychological, social and spiritual healing.