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Diabetic nephropathy is a serious complication of type 1 diabetes and type 2 diabetes. It's also called diabetic kidney disease. In the United States, about 1 in 3 people living with diabetes have diabetic nephropathy. Diabetic nephropathy affects the kidneys' ability to do their usual work of removing waste products and extra fluid from your body. The best way to prevent or delay diabetic nephropathy is by maintaining a healthy lifestyle and adequately managing your diabetes and high blood pressure. Over many years, the condition slowly damages your kidneys' delicate filtering system. Early treatment may prevent or slow the disease's progress and reduce the chance of complications. Kidney disease may progress to kidney failure, also called end-stage kidney disease. Kidney failure is a life-threatening condition. At this stage, treatment options are dialysis or a kidney transplant. Symptoms In the early stages of diabetic nephropathy, you would most likely not notice any signs or symptoms. In later stages, signs and symptoms may include: Worsening blood pressure control Protein in the urine Protein in the urine Increased need to urinate Reduced need for insulin or diabetes medicine Confusion or difficulty concentrating Shortness of breath Loss of appetite Nausea and vomiting Persistent itching Fatigue