There is no cure for diabetic nephropathy. Treatment for diabetic nephropathy depends on how severely the kidneys are damaged by diabetes. Treatment includes ongoing therapy for diabetes, such as insulin, oral hypoglycemic medications, and weight loss. Additional treatment includes ACE inhibitor medications, angiotensin receptor blockers, and a kidney diet.

Closely regulating blood glucose levels can help to slow the progression of diabetic kidney disease. In severe cases, kidney failure may occur. Treatment for kidney failure includes kidney dialysis or a kidney transplant.

Treatment for diabetic nephropathy may include:

• Medication to control high blood sugar:
• Insulin
• Oral hypoglycemic medications
• Weight loss
• Multivitamin supplements
• ACE inhibitor medications
• To control high blood pressure
• Can reduce the risk of heart attack, stroke, and premature death in people with diabetes
• Angiotensin receptor blockers
• To control high blood pressure
• Medications for high phosphate levels:
• Aluminum hydroxide
• Calcium carbonate
• Other medications:
• Calcium channel blockers
• Beta blockers
• Diuretics
• Kidney diet
• Protein restriction of 0.8 to 1 gram of protein per kilogram body weight per day
• Kidney dialysis
• Kidney transplant
• Patients should be advised to avoid nonsteroidal anti-inflammatory medications, aspirin, and other medications that are broken down by the kidney. Acetaminophen can be used for pain because it is not broken down by the kidneys.

The following are some important questions to ask before and after the treatment of diabetic nephropathy.

Questions to ask before treatment:

• What are my treatment options?
• Is surgery an option for me?
• What are the risks associated with treatment?
• Do I need to stay in the hospital?
• How long will I be in the hospital?
• What are the complications I should watch for?
• How long will I be on medication?
• What are the potential side effects of my medication?
• Does my medication interact with nonprescription medicines or supplements?
• Should I take my medication with food?

• How do I change my diet?
• What is a diabetes diet?
• Do I need to lose weight?
• Are there any medications or supplements I should avoid?
• When can I resume my normal activities?
• When can I return to work?
• Do I need a special exercise program?
• What else can I do to reduce my risk for complications?
• How often will I need to see my doctor for checkups?
• What local support and other resources are available?

Physicians from the following specialties evaluate and treat diabetic nephropathy:

• Family Practice
• Internal Medicine
• Nephrology

Last Updated: Jun 10, 2011 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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