Diabetic Nephropathy

2 medicines

Diabetic nephropathy is kidney damage caused by long-term high blood glucose injuring the kidney's filtering vessels. It's slowed by controlling blood sugar and blood pressure together, often with losartan or irbesartan.

Avapro

Irbesartan

150/300mg

Avapro is a heart blood pressure medication containing Irbesartan, available as 150/300mg tablets.

from $1.06 / tablet View

Cozaar

Losartan

25/50/100mg

Cozaar is a heart blood pressure medication containing Losartan, available as 25/50/100mg tablets.

from $0.54 / tablet View

Key facts

  • Diabetic nephropathy is kidney damage that develops when persistently high blood glucose injures the tiny filtering vessels inside the kidneys.
  • It's among the leading causes of chronic kidney disease in people with long-standing diabetes.
  • The most effective strategy is controlling blood glucose and blood pressure together; medicines such as losartan and irbesartan protect kidney function beyond their blood-pressure-lowering effect.
  • If protein in the urine doesn't come down despite treatment, a specialist review is warranted.

How the kidneys are affected

In the early stages the kidneys actually filter more blood than normal, and the only detectable sign is a small amount of protein in the urine (microalbuminuria). Over years, without adequate blood sugar and blood pressure control, the filtering units scar and lose function. Blood pressure tends to rise as kidney function falls, and the two problems drive each other in a cycle that accelerates decline. Risk rises with how long someone has had diabetes and how well blood sugar has been controlled over that time, which is why regular screening with a urine albumin test and a blood test for kidney function is recommended for anyone with diabetes, even before symptoms appear.

Slowing its progression

The most effective strategy is controlling both blood glucose and blood pressure simultaneously. Medicines that block the renin-angiotensin system, such as losartan and irbesartan, reduce pressure inside the kidney's filtering units and are widely used to protect kidney function beyond their blood-pressure-lowering effect. More detail on this drug class is in the heart and blood pressure category. Reducing dietary sodium and protein, stopping smoking, and keeping weight in a healthy range all reinforce the effect of medicines.

When to see a doctor

If protein in the urine does not come down despite treatment, or if swelling, breathlessness, or a marked drop in urine output develops, a specialist review is warranted.

This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.