Treatments and Prognosis

The main treatment for diabetic nephropathy is medicine to lower blood pressure and prevent/slow the damage to the kidneys. The type of medication used to do this is Angiotensin-converting enzyme inhibitors (ACE inhibitors), and Angiotensin II receptor blockers (ARBs), combined both can protect the kidneys better than the medication alone, and more than one may need to be taken, especially if a person has high blood pressure. ACE inhibitors can lower the amount of protein lost in the urine, and may also reduce the risk of heart and blood vessel diseases. Angiotensin II receptor blockers have a substance that causes blood vessels to narrow resulting in the blood vessels to relax and widen, making it easier for blood to flow through the vessels which reduces blood pressure, and can also increase the release of water and salt to the urine which can also result in lowering blood pressure.
If taking other medicines avoid ones that damage or stress the kidneys such as nonsteroidal anti-inflammatory drugs (NSAIDs).

 

The American Diabetes Association recommends that keeping blood pressure under control (under 130/80) is one of the best ways to slow kidney damage. Because people who have diabetes are 2 to 4 times more likely than those who don't have diabetes to die of heart and blood vessel diseases eating a low-fat diet can help prevent heart attack, stroke, and other disease having to do with the large blood vessel. Taking medication to control blood cholesterol, and getting regular exercise can also help prevent/slow kidney damage. Limiting salt, protein, caffeine and alcohol can also slow the damage to the kidneys. Keeping control on blood sugar levels can also slow kidney damage by preventing damage to the small blood vessels in the kidneys, and this can be done by eating a healthy diet, taking insulin regularly or other medicines the doctor prescribes, and checking and keeping records of blood sugar levels.

Treatment for end stage renal disease (ESRD) are dialysis and kidney transplant, although the survival for diabetic patients on dialysis is lower than non-diabetic patients.  According to MedlinePlus there are two main types of dialysis, hemodialysis and peritoneal dialysis. Both types filter the blood to rid the body of harmful wastes, extra salt and water. Hemodialysis does that with a machine, and peritoneal dialysis uses the lining of the abdomen, called the peritoneal membrane, to filter the blood, both require a special diet to be followed afterwards. Alternative treatments for treating the symptoms are vitamins of supplements such as Alpha-Lipoic Acid, Bitter Melon, Green Tea, and Wheat Bran. Food changes that should take place when dealing with this disease is the reduction of salt intake, phosphorus and potassium, as well as taking Vitamin D and having a low-protein diet.

Diabetic nephropathy is a major cause of sickness and death in people with diabetes. Regardless of treatment, chronic kidney failure in most people will progress, but if caught in the early stages kidney damage may be slowed with treatment. If not treated or controlled kidney failure is very dangerous and can lead to the need for dialysis or a kidney transplant. People with kidney failure or end-stage kidney failure, usually have several month to live if not treated, but those who are treated with dialysis can live longer. Even though one may be treated with dialysis, most people with end-stage kidney failure die within 5 to 10 years.