In patients with albuminuria, blood pressure regulation is of critical importance in slowing the progression to renal failure. Other strategies that may slow the progression of renal disease include limiting the patient's protein intake, maintaining good glycemic control, promptly treating urinary tract infections, and avoiding potentially nephrotoxic drugs and radiographic dyes. At the time of initial diagnosis, all diabetic patients should have a urinalysis performed. In general, the protein excretion rate is about one third greater than that for albumin. Measurement of renal function each year.
Hypertension is a common development with the onset of diabetic nephropathy or shortly thereafter.
At present, no known interventions have been shown to reverse clinical diabetic nephropathy. Achievement of good glycemic control, without undue side effects from hypoglycemia, in all diabetic patients. Diabetic nephropathy should receive yearly eye examinations. Cardiovascular risk factors should be assessed. Cigarette smoking is discouraged.