Diabetic nephropathy is nephropathy caused by diabetes. In severe cases it leads to kidney failure. Also known as Kimmelstiel-Wilson syndrome, diabetic nephropathy is caused by angiopathy of capillaries in the kidney glomeruli. This means that excesive sugar in the blood for a long period of time can destroy the kidney nephrons glomeruli. It involves nephrotic syndrome and diffuse glomerulosclerosis. It is caused by longstanding diabetes mellitus, and is a prime indication for dialysis in many Western countries.
The diabetic nephropathy can be seen in patients with chronic diabetes, so patients are usually of older age (between 50 and 70 years old). The disease is progressive and may cause death two or three years after the initial lesions, and is more frequent in men. Diabetic nephropathy is the most common cause of chronic kidney failure and end-stage kidney disease in the United States. As diabetic nephropathy progresses, increasing numbers of glomeruli are destroyed by nodular glomerulosclerosis. Now the amounts of albumin being excreted in the urine increases, and may be detected by ordinary urinalysis techniques. At this stage, a kidney biopsy clearly shows diabetic nephropathy.
In the first stages of diabetic nephropathy there are no symptoms. That is why it is important to have regular urine tests to find kidney damage early. Sometimes early kidney damage can be reversed, but not always. The first sign of kidney damage is a small amount of protein in the urine, which is found by a simple urine test.