Nephropathy means kidney disease or damage. Diabetic nephropathy is damage to your kidneys caused by diabetes. In severe cases it can lead to kidney failure. But not everyone with diabetes has kidney damage. The kidneys have many tiny blood vessels that filter waste from your blood. High blood sugar from diabetes can destroy these blood vessels. Over time, the kidney isn't able to do its job as well. Later it may stop working completely. This is called kidney failure.
Diabetic nephropathy is treated with medicines that lower blood pressure and protect the kidneys. These medicines may slow down kidney damage and are started as soon as any amount of protein is found in the urine. The use of these medicines before nephropathy occurs may also help prevent nephropathy in people who have normal blood pressure. If you have high blood pressure, two or more medicines may be needed to lower your blood pressure enough to protect the kidneys. Medicines are added one at a time as needed.
Diabetes is a challenging disease for patients, and a major and underestimated source of medical costs and lost productivity for society. 1.0-1.1M diabetes patients (~100,000 more diagnosed patients than reported). EUR 4-5 B total medical costs for diabetes patients, of which EUR 2.5 B costs for diabetes treatment and complications (more than double of reported). On top that EUR 6 B lost productivity Total costs could rise to EUR 16-19 B in 2020, Diabetes care in The Netherlands has reached a high level of quality, but there is still opportunity for further improvement
Inhibition of the renin-angiotensin system is important to reduce intra glomerular pressure but other classes of antihypertensive agent may also be needed to gain adequate control of systemic blood pressure. Such measures can at least half the rate of progression of nephropathy and cardiovascular disease.