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Diabetic Nephropathy — Screening and Management

Early detection of chronic renal complications of diabetes.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Internal Medicine department. Book Appointment →

What is Diabetic Nephropathy — Screening and Management?

Diabetic nephropathy is a progressive renal disease in which chronic hyperglycaemia damages the glomeruli, with albuminuria and a fall in GFR. It is the leading cause of end-stage renal disease, underlying about 40–50% of dialysis patients.

It first appears as microalbuminuria (UACR 30–300 mg/g) and may progress to macroalbuminuria (>300 mg/g) and then to a fall in GFR. Annual screening is recommended from 5 years after diagnosis in type 1 diabetes and from diagnosis in type 2 diabetes.

RAAS blockade (ACEi/ARB) and SGLT2 inhibitors are evidence-based therapies that slow the progression of nephropathy. Finerenone (a non-steroidal mineralocorticoid receptor antagonist) provides additional renal protection in diabetic kidney disease.

Symptoms

Asymptomatic in the early stages (detected on screening)
Foamy urine (albuminuria)
Leg oedema
Worsening of hypertension
Uraemic symptoms in advanced stages (fatigue, nausea, pruritus)

Risk Factors

Long duration of diabetes
Poor glycaemic control (high HbA1c)
Hypertension
Smoking
Family history of diabetic nephropathy
Obesity and dyslipidaemia

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • If microalbuminuria is detected on annual screening
  • If results suggest a falling GFR
  • If leg swelling and foamy urine develop
  • If blood pressure becomes harder to control

Treatment Methods

01
ACE inhibitor or ARB (albuminuria reduction and renal protection)
02
SGLT2 inhibitors (empagliflozin, dapagliflozin — evidence-based renal protection)
03
Finerenone (non-steroidal MRA — additional renal and cardiovascular protection)
04
Optimal glycaemic control (HbA1c <7%)
05
Blood pressure target <130/80 mmHg
06
Protein-restricted diet (0.8 g/kg/day in advanced stages)

Which Department to Visit?

You can visit our Endokrinoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.