Diabetic kidney disease (DKD) is a serious complication of diabetes that can damage the filters in your kidneys. These filters remove waste products from your blood. If you have diabetic nephropathy, your kidneys may not be able to do their job effectively. This can lead to a buildup of waste products in your blood, which can eventually lead to kidney failure. This makes regular checkups with your doctor crucial for early detection. Here's how doctors diagnose DKD:

• Urine tests: These check for the presence of albumin, a protein that shouldn't be in the urine if your kidneys are functioning properly. Moderate amounts of albumin can be a sign of early DKD.
• Blood tests: Blood tests assess how well your kidneys are filtering waste products from your blood. They measure creatinine and blood urea nitrogen (BUN) levels. Elevated levels can indicate reduced kidney function.

There is no cure for DKD, but there are treatments that can help slow its progression and prevent complications.

The main goals of treatment for DKD are to:

• Control blood sugar levels
• Lower blood pressure
• Protect the kidneys from further damage

Here are some of the treatments available for DKD:

• Lifestyle changes: A healthy diet, regular exercise, and maintaining a healthy weight are all important for managing diabetes and DKD.

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Healthy diet for diabetic kidney disease

• Exercise: Regular exercise can help improve blood sugar control and lower blood pressure. Aim for at least 30 minutes of moderate-intensity exercise at least 5 days of the week.
• Weight management: If you are overweight or obese, losing weight can help improve your blood sugar control and reduce your risk of kidney complications.
• Blood sugar control: Medications such as metformin, and insulin can help control blood sugar levels. Newer medications, such as SGLT2 inhibitors (like Invokana, Jardiance, or Farxiga) and GLP-1 receptor agonists (Like Trulicity, Rybelsus or Ozempic) may also be helpful for people with DKD to slow kidney disease progression and reduce protein leakage.
• Blood pressure control: Angiotensin-converting enzyme (ACE) inhibitors (like lisinopril or enalapril) or angiotensin receptor blockers (ARBs) like (losartan or olmesartan) are the preferred medications for lowering blood pressure in people with DKD as it also delays progression of kidney disease. You must be careful to hold these on sick days.
• Other medications: Other medications may be prescribed to help control cholesterol levels, anemia, and other complications of diabetes and DKD.

In some cases, people with DKD may eventually need dialysis or a kidney transplant. Dialysis is a procedure that removes waste products from the blood when the kidneys are no longer able to do so. A kidney transplant is a surgical procedure in which a healthy kidney from a donor is transplanted into the recipient.

If you have diabetes, it is important to get regular checkups to screen for kidney disease. Early detection and treatment can help to slow the progression of kidney damage and prevent other complications. Talk to your doctor about the best course of treatment for you.