Diabetic Nephropathy - Treatment Overview
Diabetic nephropathy is treated with medicines that lower blood pressure and
protect the kidneys. These medicines may reverse kidney damage and are started
as soon as any amount of protein is found in the urine (microalbuminuria). The
use of these medicines before nephropathy occurs may also help prevent
nephropathy in people who have normal blood pressure.
If you have
high blood pressure, two or more medicines may be
needed to lower your blood pressure enough to protect the kidneys. Medicines
are added one at a time as needed. 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 groups may
vary. Talk with your doctor about what your target blood pressure level should
be. For more information on blood pressure medicines, see the topic
High Blood Pressure (Hypertension).
you take other medicines, avoid ones that damage or stress the kidneys,
nonsteroidal anti-inflammatory drugs (NSAIDs).
It is also important to keep your blood sugar within your target range. Maintaining blood sugar levels within your target range prevents
damage to the small blood vessels in the kidneys.
amount of salt in your diet can help keep your high blood pressure from
getting worse. You may also want to restrict the amount of protein in your
diet. If diabetes has affected your kidneys, limiting how much protein you eat
may help you preserve kidney function. Talk to your doctor or
dietitian about how much protein is best for you.
People who have diabetes are 2 to 4 times more likely than people who
don't have diabetes to die of heart and blood vessel diseases. Eating a low-fat diet can help prevent heart attack,
stroke, and other large blood vessel disease (macrovascular disease).3
Medicines that are used to treat
diabetic nephropathy are also used to control blood
pressure. If you have a very small amount of protein in your urine, these
medicines may reverse the kidney damage. Medicines used for initial treatment
of diabetic nephropathy include:
If you also have high blood pressure, two or more
medicines may be needed to lower your blood pressure enough to protect your
kidneys. Medicines are added one at a time as needed. The American Diabetes
Association recommends a target blood pressure of less than 130/80 millimeters
of mercury (mm Hg).1