Looking after your diabetes is the best way to lower the risk of developing long-term complications. Healthy eating, exercising, taking prescribed medications and attending regular check-ups with your doctor or diabetes team are all part of looking after your diabetes.

Diabetic nephropathy refers to kidney disease that can occur in people with diabetes. The kidneys help regulate the amount of fluids and salts in the body, which helps control blood pressure and the release of different hormones. Nephropathy is the term used when the kidneys start to suffer damage. If left untreated it can lead to kidney failure.

What causes nephropathy?

Diabetic nephropathy develops slowly and occurs when the kidneys become leaky, allowing albumin (a protein made by the liver) to pass into the urine. The condition worsens as the level of albumin increases.

High blood pressure and high blood glucose levels increase the risk of kidney damage. Both states harm the small blood vessels in the kidney (known as microvascular disease). As a result the small blood vessels become leaky and don’t filter properly.

How do I know if I have kidney damage?

In the early stages there are often no symptoms at all. This highlights the need to have your kidney function checked at least yearly with your doctor.

As kidney disease gets worse you may notice changes in how often you pass urine and how much you pass. Other symptoms could include:

• Tiredness
• Loss of appetite
• Difficulty sleeping
• Headache
• Loss of concentration
• Shortness of breath
• Swollen ankles
• Nausea and vomiting

What can I do to prevent kidney damage?

It is important to make sure your doctor orders a yearly urine test and blood test to check how your kidneys are working.

Keep your blood pressure and blood glucose levels within the recommended target range to reduce long term damage. Your doctor may prescribe medication to help.

Important tips

• Keep your blood pressure as close to 130/80 or less
• Keep your HbA1c as close to seven per cent or 53mmol/mol or less
• For people with type 2 diabetes: Keep your blood glucose levels as close to 6-8mmol before meals /L and 6-10mmol/L two hours after the start of a meal
• For people with type 1 diabetes: Keep your blood glucose levels as close to 4-6mmol before meals /L and 4-6 mmol/L two hours after the start of a meal
• Exercise regularly – aim for 30 minutes most days of the week
• Reduce salt intake by choosing foods that are low in salt (sodium) and limit the amount you add to meals
• Don’t smoke
• Drink plenty of water unless you are on a fluid restriction
• Watch out for urinary tract infections – cloudy or blood stained urine, burning or stinging when passing urine, and the need to urinate more often

Always check with your doctor or diabetes team what your targets should be.

For more information call your Helpline on 1300 342 238 or visit www.kidney.org.au