Nephrology, by video or in person
Diabetic Kidney Disease
The signs, the danger signs that mean hospital now, and how to see a doctor by video from anywhere in Nigeria.
Signs to look for
Diabetic Kidney Disease
- No symptoms in the early stages
- Protein in the urine, sometimes foamy urine
- Rising blood pressure
- Swelling of the ankles, feet or face
- In later stages: tiredness, poor appetite, itching, nausea and breathlessness
Over years, high blood sugar can damage the small blood vessels in the kidneys, so they leak protein and slowly lose their ability to filter the blood. This is diabetic kidney disease, also called diabetic nephropathy. It causes no symptoms until it is advanced, which is why everyone with diabetes needs a urine test (ACR) and a blood test for kidney function (eGFR) at least once a year. High blood pressure speeds it up. Found early, it can be slowed a great deal with good sugar and blood pressure control and medicines that protect the kidneys. Without that, it can lead to kidney failure needing dialysis, and it raises the risk of heart attack and stroke.
Medically reviewed by Dr Debo Odulana, Founder and Chief Executive, Mezo. Last reviewed . This page is general information, not a diagnosis. Care is decided with you after an examination.
Symptoms
- No symptoms in the early stages
- Protein in the urine, sometimes foamy urine
- Rising blood pressure
- Swelling of the ankles, feet or face
- In later stages: tiredness, poor appetite, itching, nausea and breathlessness
- Needing less diabetes medicine than before, as the kidneys clear it more slowly
When to See a Doctor
Go to a hospital now if you have diabetes and are passing very little urine, are breathless, very swollen, drowsy or confused, or are vomiting and cannot keep fluids down. See a doctor if you have diabetes and have not had a urine ACR and kidney blood test in the past year, if your results show protein or a falling eGFR, or if your blood pressure is not controlled. A nephrologist can review your results and medicines.
Treatment options
- A urine ACR and eGFR blood test at least once a year
- Keeping blood sugar in the target range agreed with your doctor
- Keeping blood pressure under control, usually with an ACE inhibitor or ARB
- Newer diabetes medicines (SGLT2 inhibitors) that also protect the kidneys, where suitable
- A statin to protect the heart
- Less salt, no smoking, and no painkillers such as ibuprofen or diclofenac without advice
- Checking doses of metformin and other medicines as kidney function changes
Common Questions
Can kidney damage from diabetes be reversed?
Early damage can sometimes improve, and progression can be slowed a great deal with good control and the right medicines. Lost kidney function usually does not come back, which is why yearly testing matters.
Should I stop metformin if my kidneys are affected?
Do not stop any medicine on your own. Your doctor may lower the dose or change it depending on your eGFR.
Can a nephrologist help by video?
Yes. Much of this care is reading urine and blood results and adjusting medicines, which a kidney specialist can do on a call, with tests arranged near you.
Need Help?
A kidney specialist on a video call, who reads your kidney results, adjusts your medicines and says when you need to be seen in person.
See a nephrologist by videoIf any of the danger signs on this page applies, go to the nearest hospital now instead.
Find a verified nephrology specialist near you.
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