Diabetic nephropathy is a common complication associated with diabetes that affects a person’s kidneys. Several medications may help slow the progression of kidney damage.

Diabetic nephropathy is associated with both type 1 and type 2 diabetes. It is the main cause of end stage kidney disease in the United States and other developed countries worldwide. About 30–40% of people living with diabetes will develop the condition.

Early treatment can prevent or delay the progression of kidney damage. Treatment often consists of medications as well as taking steps to help manage diabetes, such as through exercise.

This article discusses medications a doctor may suggest to treat diabetic nephropathy, other management strategies, alternative treatments, and more.

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Medications doctors use to treat diabetic nephropathy can help slow the progression of the disease. Currently, the Food and Drug Administration (FDA) has approved two medications to slow the disease’s progression. They include dapagliflozin (Farxiga), which is a sodium-glucose co-transporter-2 (SGLT2), and finerenone (Kerendia), which is a nonsteroidal, selective mineralocorticoid receptor antagonist.

Dapagliflozin may help reduce progression of kidney disease in people living with diabetes. Finerenone may also help reduce the progression of kidney disease in people living with diabetes, but the long-term side effects are still unknown.

In addition, a doctor may also provide angiotensin receptor blockers (ARBs) and angiotensin converting enzyme (ACE) inhibitors as effective options for people living with diabetic kidney disease.

A large part of managing diabetic nephropathy and preventing its development involves several management strategies. Experts note this involves four areas:

  • cardiovascular risk reduction
  • glycemic — blood sugar — management
  • blood pressure management
  • inhibition of the renin-angiotensin system

The Centers for Disease Control and Prevention (CDC) note that a person can take help care of their kidneys by:

A doctor may also advise people to quit smoking, if applicable.

Taking these steps can help manage and prevent kidney damage, as well as other potential complications, such as cardiovascular disease.

If medications and lifestyle changes are not effective and kidney disease progresses, a person may need more advanced treatment. The treatment for individuals with failing kidneys may include either kidney transplantation and dialysis.

A person typically only requires one of these options if they develop end stage kidney disease. Medications and lifestyle changes may help prevent a person living with diabetes from reaching the end stage and preserving as much kidney function as possible.

Many of the lifestyle changes that can form part of a treatment plan can also help a person prevent diabetic nephropathy. Prevention strategies can include:

  • monitoring and maintaining healthy blood sugar levels
  • taking steps to manage blood pressure
  • stopping smoking
  • getting regular physical activity
  • following a balanced diet
  • maintaining a moderate weight
  • aiming for 7–8 hours of sleep each night
  • taking medications as a doctor prescribes

Taking these steps may not stop kidney disease from developing, but they can help. Many of the strategies may also help a person prevent other complications, such as heart disease or obesity. A person can work with a doctor or other members of a diabetes healthcare team to develop strategies to help prevent kidney damage.

Some people may benefit from working with a dietitian to help develop a plan for what to eat and what to avoid. Others may find that working with a personal trainer or joining a group fitness class may help them maintain a moderate weight or get enough physical exercise.

A person can take measures to improve their sleep hygiene. This can include:

  • removing electronics from the bedroom
  • making the room dark
  • going to sleep at the same time each night
  • making a comfortable environment for sleep

Learn more about preventing diabetic kidney disease.

Medications can help treat diabetic nephropathy and prevent further kidney damage. A person may also find that lifestyle changes may help both prevent and manage kidney damage.

If kidney damage progresses, a person may need dialysis or a kidney transplant. A person should consider working with a doctor or other members of a healthcare team to help manage and prevent kidney damage.