Signs and Symptoms of Diabetic Nephropathy 

How do we know the signs and symptoms of Diabetic Nephropathy if we don’t know what signs and symptoms are? Before getting into any one particular disease, being able to distinguish between a sign and a symptom. 

-          Sign: a sign is anything measurable (like a temperature or BP reading), or apparent to an observer

-          Symptom: a symptoms is a condition reported by the patient experiencing it (like dizziness or a headache)

So signs and symptoms are different, but we can learn from both of them to get clues about a particular disease or condition. Let’s try an example- here’s a list of signs and symptoms. Can you guess what is wrong?

Signs	Symptoms
-          Red, edematous tissue on the wrist joint -          Ecchymosis at the wrist and palm -           Increase heart rate of 98 beats per minute -          Diaphoresis -          Increased respiratory rate of 26 breaths per minutes	-          Patient reports severe pain, tenderness at the wrist -          Inability to rotate, grip, or pick up a pencil

If you determined that it was a broken wrist, you are correct!

Now that you better understand signs and symptoms, the signs and symptoms of Diabetic Nephropathy will make a lot more sense.

Signs of DN	Symptoms of DN
Excess of microalbumin in the urine (30-300 mg/L is considered microalbuminurea, >300 mg/L is macroalbuminurea)	Itching skin
Decreased GFR (below 60 mL/min/1.73 m2)	Anorexia (poor appetite)
Edema (at first around the eyes, and then later in the extremeties, particularly the legs)	Fatigue
High creatinine and BUN levels	Headache

So just because you have itching skin, or puffy eyes, doesn’t mean that you have DN. However, several of these signs and symptoms together would definitely be a warning for further testing.

American Diabetes Association. Nephropathy in Diabetes. Diabetes Care. 2004; 27 (suppl 1):S79-S83.

Epidemiology of diabetic nephropathy. Reutens AT, Atkins RC - Contrib Nephrol - ; 170; 1-7