Diabetic Kidney Disease (Nephropathy)
Protecting delicate renal microvasculature using today's proven kidney-protective therapies, seamlessly coordinated with your endocrinologist and primary care physician.
What It Is
Diabetic kidney disease is a chronic complication of type 1 and type 2 diabetes that damages the microscopic filtering units (glomeruli) within the kidneys. It is the leading cause of chronic kidney disease in the United States, yet modern medical breakthroughs now make it possible to dramatically slow or halt its progression when caught in time.
Why Your Doctor May Have Sent You
Microscopic albumin detected in your urine test (microalbuminuria) or your doctor notices a gradual upward drift in your creatinine or downward drift in your eGFR.
How Our Specialists Help
We build a modern, evidence-based renal defense strategy. Dr. Hozayen collaborates with your diabetes care provider to implement renoprotective medications (SGLT2 inhibitors, GLP-1 receptor agonists, and nonsteroidal mineralocorticoid receptor antagonists), establish healthy blood pressure goals, and protect your cardiovascular system.
Diagnostic Workup & Testing
We avoid redundant testing by reviewing recent records first, ordering only targeted diagnostic studies:
- Annual Urine Albumin-to-Creatinine Ratio (UACR)
- Serial eGFR and serum creatinine monitoring
- Hemoglobin A1c and glycemic trend review
- Lipid panel and cardiovascular risk stratification
Evidence-Based Treatment Pathways
Modern renal medicine focuses on preserving existing nephrons and preventing complications:
- First-line renoprotective agents: SGLT2 inhibitors (e.g. empagliflozin, dapagliflozin)
- ACE inhibitors (e.g. lisinopril) or ARBs (e.g. losartan) titrated to maximum tolerated dose
- Finerenone (Kerendia) for patients with persistent albuminuria and type 2 diabetes
- Guidance on low-protein and heart-healthy dietary adjustments
Common Symptoms to Monitor
- No symptoms in the early stages
- Foamy or bubbly appearance in the urine (a sign of excess protein)
- Mild ankle swelling or puffiness around the eyes
- More frequent episodes of hypoglycemia if failing kidneys break down insulin more slowly
When to See a Kidney Specialist
- UACR test shows persistent albuminuria (>30 mg/g on 2 or more tests)
- eGFR begins to decline rapidly (>3-5 mL/min per year)
- You have questions about how new kidney-protective diabetes medications fit your care