Diabetic nephropathy/Sclerosis

Alternative names:

diabetic glomerulosclerosis; diabetic kidney disease; Kimmelstiel-Wilson disease

Symptoms:

• swelling (edema) of the face, extremities, or any part of the body
• foamy appearance of the urine
• unintentional weight gain (from fluid accumulation)
• swelling of the legs
• poor appetite
• unintentional weight loss (actual loss of body mass)
• nausea, vomiting
• general ill feeling
• fatigue
• headache
• frequent hiccups
• generalized itching (pruritus)

There may be no symptoms for many years.

Additional symptoms that may be associated with this disease:

• urination, excessive volume
• thirst, excessive
• nail abnormalities
• blood pressure, high

Signs and tests:

The first laboratory abnormality is a positive microalbuminuria test. The initial diagnosis is commonly suspected when routine urinalysis on a person with diabetes shows protein in the urine (proteinuria). There may or may not be signs of other diabetic complications. Hypertension may be present or develop rapidly and may be difficult to control. Examination of the retina of the eyes (fundoscopy) may show diabetic retinopathy.

Urinalysis shows protein, including urine albumin. It may also show glucose in the urine, especially if blood glucose is poorly controlled.

Serum creatinine and BUN may increase as kidney damage progresses.

A kidney biopsy confirms the diagnosis and may be performed to evaluate the extent of diabetic nephropathy.

This disease may also alter the results of the following tests:

• protein electrophoresis - urine
• creatinine - urine
• 24-hour urine protein