Diabetic kidney disease is kidney damage caused by diabetes, also called diabetic nephropathy. As of October 2026, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) says most people with it have no symptoms, so it is found with a urine test and a blood test. The steps that slow it are blood sugar control, blood pressure control, medicines your clinician may prescribe, and healthy habits that include enough sleep. NIDDK describes slowing this damage, not curing it.
What is diabetic kidney disease?
NIDDK’s page on diabetic kidney disease lists other names for it: DKD, chronic kidney disease (CKD), kidney disease of diabetes, and diabetic nephropathy. So diabetic nephropathy and diabetic kidney disease refer to the same condition on that page. Diabetes is the leading cause of kidney disease, and about 1 out of 3 adults with diabetes has kidney disease, according to the same page.
Your kidneys filter wastes and extra water from your blood to make urine, and they help control blood pressure. High blood glucose can damage the blood vessels in the kidneys, and high blood pressure can add to that damage. Kidney damage from diabetes usually develops slowly, over many years.
Diabetic neuropathy is a different complication, and this guide focuses on the kidneys.
Is it fatal? NIDDK says most people with diabetes and kidney disease do not end up with kidney failure. Kidney failure means the kidneys have lost most of their ability to function, less than 15 percent of normal. Ask your clinician where your kidney results fall.
What raises the risk?
- diabetes that has lasted a long time
- blood glucose that runs too high
- blood pressure that runs too high
- smoking, or not following your diabetes eating plan
- eating a lot of salt, or not being active
- overweight, heart disease, or a family history of kidney failure
NIDDK also notes that African Americans, American Indians, and Hispanics/Latinos develop diabetes, kidney disease, and kidney failure at a higher rate than Caucasians.
How is diabetic kidney disease diagnosed?
Most people with diabetic kidney disease have no symptoms, so NIDDK says the only way to know is to get your kidneys checked. Health care professionals use blood and urine tests. Your clinician checks your urine for albumin and runs a blood test to see how well your kidneys are filtering your blood. NIDDK says you should be tested every year if you have type 2 diabetes, or if you have had type 1 diabetes for more than 5 years.
Before your visit, ask: Was my urine albumin checked this year? Was my kidney filtering blood test done, and what were the results?
Can diabetic kidney disease be reversed, cured, or treated?
NIDDK says kidney damage from diabetes can get worse over time, but you can take steps to keep your kidneys healthy and help slow the damage. The page describes slowing and preventing kidney damage, not curing it. NIDDK’s research program for diabetic kidney disease lists an aim to ‘prevent, reverse, and ameliorate fibrosis.’ That is a research direction. It is not a treatment you can ask for today.
So the realistic goal, as NIDDK frames it, is to slow damage and protect the kidneys. The options below are the ones the sources cover.
How do people slow diabetic kidney disease?
The table compares the main options side by side. No prices appear in these sources. Check prescription costs with your pharmacist or insurer, and check supplement prices on the label or the seller’s price page.
| Option | What the source says | Who it may suit | Limits |
|---|---|---|---|
| Blood glucose control (A1C) | NIDDK says the A1C goal for many people with diabetes is below 7 percent, and reaching your goal helps protect your kidneys. | People with diabetes, with a goal set by their care team | Goals differ by person. Ask your team what yours should be. |
| Blood pressure control | NIDDK says the blood pressure goal for most people with diabetes is below 140/90 mm Hg. | People with diabetes and high blood pressure | Goals differ by person. Ask your team what yours should be. |
| ACE inhibitors and ARBs (prescription) | NIDDK says each has been found to slow kidney damage in people with diabetes who have high blood pressure and DKD. Their names end in -pril or -sartan. | People with diabetes, high blood pressure, and DKD, as a clinician prescribes | NIDDK says these medicines are not safe for women who are pregnant. |
| Healthy habits | NIDDK lists stopping smoking, working with a dietitian on a meal plan, limiting salt, being physically active, staying at a healthy weight, and getting enough sleep. | Anyone with diabetes | People may have trouble sticking with their plan over time. |
| Sleep of 7 to 8 hours a night | NIDDK lists this among habits that help keep kidneys healthy. Its page does not cite a study of sleep and kidney outcomes. | Anyone | See the sleep section below for what the research covers. |
| Clinical trials (investigational) | NIDDK’s research program funds basic research, natural history studies, and clinical trials. Related trials are listed on ClinicalTrials.gov. | People interested in research who can discuss eligibility with a clinician | Trials test ideas that are not yet standard care. |
| Dietary supplements | Whether any supplement protects the kidneys is not yet established. | Not a substitute for the steps above | Ask your clinician whether any supplement you use could matter for your kidneys. |
What does sleep have to do with diabetic kidney disease?
The published studies below look at a different question. They examine obstructive sleep apnea (OSA), not how many hours you sleep.
A 2025 systematic review and meta-analysis in Frontiers in endocrinology pooled 14 articles with 5,316 subjects. It found that patients with OSA had a 1.92-fold increased risk of DKD compared with controls (OR = 1.92, 95% CI: 1.59, 2.32). The authors describe a significant bidirectional association and a mutual exacerbation of risks. They call for enhanced OSA screening in diabetic populations and regular renal function monitoring in OSA patients. 2025 sleep apnea and kidney disease review
A 2016 systematic review and meta-analysis in Sleep found moderate evidence that OSA is associated with DKD in people with type 2 diabetes (pooled OR 1.73, 95% CI 1.13 to 2.64). It found no evidence on associations between OSA and other respiratory measures in people with type 1 diabetes, and its authors called for large prospective studies with long-term follow-up. 2016 sleep apnea and kidney review
What this means for you: an association is not the same as proof that one causes the other. Ask your clinician whether a sleep apnea screen makes sense for you.
What about supplements and products sold for diabetes?
If you have diabetes, ask your clinician whether any supplement you use could matter for your kidneys.
The U.S. Food and Drug Administration (FDA) has a page on illegally sold diabetes treatments that lists companies it has sent warning letters to. You can ask your clinician about any supplement you take. This is information, not legal advice. FDA illegally sold diabetes treatments warning
What is not known yet?
- Whether total sleep duration changes kidney outcomes. The sources above study sleep apnea, not total sleep duration.
- Whether diabetic kidney disease can be cured. NIDDK describes slowing it.
- Whether any supplement protects the kidneys is not yet established.
- The NIDDK diabetic kidney disease page shows a last review in February 2017, so ask your clinician about newer guidance.
Questions to bring to your clinician
- Were my urine albumin and kidney filtering tests done this year?
- What are my A1C and blood pressure goals?
- Would an ACE inhibitor or ARB be a fit for my situation?
- Should I be screened for sleep apnea, given how I sleep?
- Is any supplement I take a concern for my kidneys?
- Are there clinical trials I might qualify for?
What is your next step?
Before your next visit, write down your sleep pattern and any changes you notice. Our guide to building a symptom timeline for a primary care appointment shows how. Then list your questions with our guide to preparing questions about a new or changed prescription.
By the Primary Care Visit Guide Team
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