How does diabetic nephropathy affect the kidneys?

Diabetic nephropathy is a complication of diabetes mellitus that causes the progressive deterioration of kidney function. The condition primarily damages the nephrons—the functional units responsible for filtering waste from the blood—often due to the combined effects of chronic hyperglycemia and hypertension.1

As the disease progresses, it leads to several critical physiological changes:
* Increased Albuminuria: The kidneys begin to excrete abnormally high levels of the protein albumin into the urine.1
* Reduced Filtration: The glomerular filtration rate, which measures how effectively the kidneys clear waste from the blood, steadily declines.1
* Vascular Damage: High blood sugar facilitates the formation of advanced glycation end products (AGEs), which damage renal blood vessels.1

If left unmanaged, these changes can lead to end-stage renal disease, where kidney function is severely diminished or lost entirely. Treatment focuses on strictly controlling blood glucose and blood pressure through diet, exercise, and medications like insulin or ACE inhibitors to slow the damage.1