diabetic nephropathy

For people with diabetic nephropathy, doctors may provide drug therapy and invasive medical procedures which, in most cases, merely delay "end stage" damage — permanent physical damage that profoundly affects quality of life. Fortunately, diabetic nephropathy is a potentially reversible health condition.

Contact us today and let us help you start the reversal process. In the meantime, consider the following facts about diabetic nephropathy:

  • The kidneys perform two main functions. They filter out waste products and they help control blood pressure.
  • Diabetic nephropathy refers to kidney damage caused by diabetes. High blood sugar levels (hyperglycemia) damages the kidneys in two ways. One, it raises the level of particular chemicals that cause the filters of the kidneys (the glomeruli) to leak abnormal amounts of protein through the kidneys into the urine. Two, it causes some of the proteins in the glomeruli to link together, triggering a localizing scarring process (glomerulosclerosis).
  • Diabetic nephropathy has five stages:
stage 1

Hyperfunction and Hypertrophy Stage is characterized by enlarged kidneys (hypertrophy) and a filtration rate, or globerular filtration rate (GFR), that is normal-to-high. A potential result of such hyperfiltration is an excess output of urine (polyuria). It is estimated that this stage occurs around the same time of the onset of the diabetes.

stage 2

The Silent Stage may show an increased thickness of the glomerular basement membrane (a part of the kidneys’ filtration barrier) and a further increase of the patient’s GFR. This stage occurs within the first 5 years from when the diabetes first began.

stage 3

The Incipient Stage presents damaged capillaries that allow an elevated level of protein (albumin) to escape through the kidneys into the urine (a state called microalbuminuia). During this stage, the GFR begins to fall. All of these signs tend to occur between years 6 and 15, post diabetes onset.

stage 4

The Overt Stage presents increasing levels of albumin in the urine (macroalbuminuria), and lowering levels of albumin in the blood. These changes may result in noticeable edema in many patients. This stage, often referred to as chronic kidney disease or proteinuria, has been known to occur between years 16 and 25, post diabetes onset.

stage 5

The Uremic Stage is also referred to as kidney failure or end-stage kidney disease. At this stage, the kidneys are no longer capable of ridding the body of certain waste and toxins. This may occur between years 15 and 30, post diabetes onset.

  • Some newly diagnosed type 2 diabetes patients have diabetes-related kidney damage and some do not. It has been estimated that up to 12% of patients newly diagnosed with type 2 diabetes have Stage 3 diabetic nephropathy, and up to 2% have Stage 4. For patients newly diagnosed with type 2 diabetes whose kidneys are fully functioning, it has been estimated that within 5 years, 15% of those patients will develop Stage 3 diabetic nephropathy and 5% will develop Stage 4.
  • Overall, kidney damage rarely occurs in the first 10 years after the onset of diabetes, and 15 to 30 years may pass before Stage 5 occurs if it occurs at all. And while some people who live with diabetes for more than 25 years never experience any signs of diabetic nephropathy, in the US, approximately 20% of patients with type 2 diabetes will develop diabetic nephropathy within 20 years after the onset of their diabetes.
  • Diabetic nephropathy accounts for approximately 40% of all new cases of end-stage renal (kidney) disease in the US, and many of those patients live on chronic dialysis or with a transplanted kidney.
  • Research indicates that the onset and course of diabetic nephropathy can be altered if not reversed and that effective intervention has the greatest impact if instituted early.

Diabetic nephropathy is a potentially reversible health condition that Fettler Health can help you reverse if targeted early. If it is not reversed, the following complications associated with diabetic nephropathy — some of which are also potentially reversible — have been known to occur:

no signs or symptoms

No Symptoms

People with prediabetes and type 2 diabetes often have undiagnosed diabetic nephropathy, or chronic kidney disease (CKD), and don’t know that they have it. This is because, throughout its early course, diabetic nephropathy has no symptoms. However and fortunately, signs of kidney damage, including reduced kidney function, are detectable through medical testing. In turn, once diagnosed and targeted early, diabetic nephropathy is potentially reversible.

high blood pressure

High Blood Pressure

When the force of blood flow is high, as it is for individuals with high blood pressure, blood vessels stretch in order to allow blood to flow more easily. Eventually, this stretching scars and weakens blood vessels throughout the body, including the blood vessels of the kidneys. If the kidneys’ blood vessels are damaged, they may stop removing wastes and extra fluid from the body. Extra fluid in the blood vessels may then raise blood pressure even more, creating a dangerous cycle.

kidney damage

Kidney Damage

Diabetes often leads to kidney damage. Early effects of kidney damage include accelerated filtering (hyperfiltering) by the kidneys. Other effects include excessive outputs of urine (polyuria), abnormal amounts of protein in the urine (albuminuria), and high levels of waste products (creatinine) in the blood.



In its later stages, diabetic nephropathy results in edema (swelling) which may include swelling around the eyes in the morning, swelling of the legs, and unintentional weight gain as a result of fluid accumulation. Such swelling usually occurs first in the feet and legs, and later throughout the whole body.


Kidney Dialysis

Individuals with Stage 5 diabetic nephropathy, otherwise known as kidney failure or end-stage renal disease (ESRD), require dialysis or a kidney transplant. Kidney dialysis is an artificial blood-cleaning process. In the US, the average survival for a patient with ESRD on dialysis is 4 to 5 years, with death most likely resulting from either infection or cardiovascular events.


Kidney Transplant

Kidney failure, or irreversible end-stage kidney disease, requires either dialysis or a kidney transplant. Kidney transplantation refers to receiving a healthy kidney from a donor. National statistics indicate that up to 97% of kidney transplants are working at the end of a month, 93% are working at the end of a year, and 83% are working at the end of 3 years. The reasons why a kidney transplant can fail include clot, fluid collection, infection, side effect of medication, recurrent disease, and rejection. Every year, over 20% of kidney transplants are re-transplants.

Fettler Health provides the tools and services to help you reverse potentially reversible health conditions including those listed below.
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