Diabetic nephropathy is diagnosed using tests that check for a protein (albumin)
in the urine, which points to kidney damage. Your urine will be
checked for protein (urinalysis) when you are diagnosed with
Microalbumin urine tests can detect
very small amounts of protein in the urine that cannot be detected by a routine
urine test, allowing early detection of nephropathy. Early detection is
important, to prevent further damage to the kidneys. The results of two tests,
done within a 3- to 6-month period, are needed to diagnose nephropathy.
When to begin checking for protein in the urine depends on the type of
diabetes you have. After testing begins, it should be done every year.1
| Type of diabetes|| When to begin yearly
Type 1 diabetes
After you have had diabetes for
Type 2 diabetes
When you are diagnosed with
Diabetes present during
After age 10 and after the child has had diabetes for 5 years
A microalbuminuria dipstick test is a simple test that can
detect small amounts of protein in the urine (microalbuminuria, also called
proteinuria). The strip changes color if protein is present, providing an
estimate of the amount of protein. A spot urine test for microalbuminuria is a
more precise lab test that can measure the exact amount of protein in a
urine sample. Either of these tests may be used to test your urine for protein.
You will also have a
creatinine test done every year. The creatinine test
is a blood test that shows how well your kidneys are working.
your doctor suspects that the protein in your urine may be caused by a disease
other than diabetes, other blood and urine tests may be done. You may have a
small sample of kidney tissue removed and examined (kidney biopsy).
It is important to check your blood
pressure regularly, both at home and in your doctor's office, because blood
pressure rises as kidney damage progresses. About one-third of people with type
2 diabetes have
high blood pressure at the time diabetes is diagnosed.
The American Diabetes Association recommends a target blood pressure of less
than 130/80 millimeters of mercury (mm Hg).1 The level
recommended by other organizations may vary. Talk with your doctor about what
your target blood pressure level should be. Keeping your blood pressure at or
below this target can prevent or slow kidney damage.
triglycerides also should be checked regularly to see
nephrotic syndrome, or other factors are raising your
blood cholesterol level.
High cholesterol can increase the risk of hardening of
the arteries (atherosclerosis), possibly leading to heart disease,
peripheral arterial disease, and stroke.