Kimmelstiel-Wilson disease; Diabetic glomerulosclerosis; Nephropathy - diabetic
Often, there are no symptoms as the kidney damage starts and slowly gets worse. Kidney damage can begin 5 to 10 years before symptoms start.
People who have more severe kidney disease may have a poor appetite, feel tired most of the time, and have a general ill feeling.
See also: End stage kidney disease
Tests your doctor orders can often find signs of kidney problems in the early stages.
Once a year, you should have a urine test. It looks for a protein called albumin. Because the test looks for small amounts of albumin, it is sometimes called a test for microalbuminuria.
When you have diabetes, your doctor will test your urine for too much protein at least once a year. Too much protein is often a sign of kidney damage.
High blood pressure often goes along with diabetic nephropathy. You may have high blood pressure that begins quickly or is hard to control.
Your doctor will also check your kidneys with the following blood tests every year:
Other lab tests that may be done include:
A kidney biopsy confirms the diagnosis. However, your doctor can often diagnose the condition without a biopsy. A biopsy is done if there is any doubt about the diagnosis.
American Diabetes Association. Standards of medical care in diabetes--2011. Diabetes Care. 2011 Jan;34 Suppl 1:S11-61.
Inzucchi SE, Sherwin RS. Diabetes Mellitus. In: Goldman L, Ausiello D, eds. Cecil Textbook of Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 248.
American Diabetes Association (2004). Nephropathy in diabetes. Clinical Practice Recommendations 2004. Diabetes Care. 27(Suppl 1): S79ï¿½S83.
Parving H, Mauer M, Ritz E. Diabetic Nephropathy. In: Brenner BM. Brenner and Rector's The Kidney. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 36.
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