Can diabetic nephropathy cause blood in urine?

Written by Zhou Qi
Nephrology
Updated on May 28, 2025
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Generally speaking, diabetic nephropathy does not cause hematuria. The main site of damage in diabetic nephropathy is indeed the glomerulus. Prolonged hyperglycemia and metabolic disorders can lead to damage to the capillaries of the glomerulus. However, the main clinical characteristic of this damage is proteinuria, which causes glomerulosclerosis and may also lead to renal failure, but it is rare for patients to have red blood cells in their urine or to experience hematuria. Therefore, if a patient with diabetic nephropathy has visible hematuria, such as red or tea-colored urine, it is necessary to check for other causes beyond diabetes, such as urinary tract infections, urogenital system stones, tumors, etc., all of which can cause hematuria.

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Written by Zhou Qi
Nephrology
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Is stage three diabetic nephropathy severe?

Stage three of diabetic nephropathy refers to patients who have persistent microalbuminuria, indicating a relatively mild state of the disease at this time. In fact, diabetic nephropathy is divided into five stages. During the first and second stages, patients generally do not exhibit specific symptoms clinically and may even test negative for proteinuria; however, an increase in kidney size and glomerular filtration rate may occur. By the third stage, patients begin to exhibit small or micro amounts of urinary albumin. The pathological damage to the kidneys at this stage is not considered particularly severe. Patients may experience hyalinization of small arteries and nodular lesions in the glomeruli. Within the staging of diabetic nephropathy, this does not constitute a particularly severe phase; however, the condition of the patients may continue to progress, leading to significant proteinuria and even renal failure.

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Written by Luo Han Ying
Endocrinology
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Is early diabetic nephropathy reversible?

Diabetic nephropathy clinically mainly manifests as an increase in urine protein on routine urine tests. Thus, diabetic nephropathy can be classified into different stages. In the early stages, microalbuminuria appears, and at this early phase, diabetic nephropathy is actually reversible. However, if the condition progresses with significant proteinuria, it becomes difficult to reverse diabetic nephropathy through intervention treatments. Most clinical patients may experience a slight reduction in urine protein or maintain this condition long-term without further progression. However, some patients have already experienced an increase in creatinine levels by the time they reach this stage of diabetic nephropathy, making it particularly challenging to reverse the condition once creatinine levels rise. Therefore, for diabetic nephropathy, early detection and treatment are crucial, with the most important goal being the prevention of the disease's onset.

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Written by Zhou Qi
Nephrology
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Can diabetic nephropathy undergo kidney transplantation?

Diabetic nephropathy has now become the leading cause of uremia in China, accounting for the largest proportion. In the 1980s and 1990s, chronic nephritis was the most common cause of uremia in China. Over the past decade, diabetic nephropathy has gradually surpassed chronic nephritis and become the leading condition. This condition requires dialysis or a kidney transplant when it progresses to uremia. Patients with diabetic nephropathy in a uremic state can undergo a kidney transplant. After the transplant, these patients still need to use medications to control their blood sugar and blood pressure, to prevent high blood sugar and high blood pressure from further damaging the new kidney. Of course, if conditions allow, performing a combined kidney and pancreas transplant might yield better results.

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Written by Zhou Qi
Nephrology
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How is diabetic nephropathy diagnosed?

The diagnosis of diabetic nephropathy primarily relies on the clinical symptoms and medical history of the patient. Such patients often exhibit proteinuria, sometimes even severe proteinuria, and may also experience renal failure. Additionally, these patients have a history of diabetes, usually extending over ten years, followed by renal damage, and often accompanied by diabetic retinopathy. In such cases, a preliminary diagnosis can be made based on clinical features. However, there is still a risk of misdiagnosis, as the proteinuria could also be caused by other diseases affecting the glomeruli. Therefore, to confirm the diagnosis, it is best to conduct a renal biopsy, which can provide a definitive diagnosis.

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Written by Zhang Jun Jun
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What should I do if diabetic nephropathy causes facial swelling?

Diabetic nephropathy with facial swelling is generally due to too much protein in the urine and too little protein in the blood, causing hypoalbuminemia, which leads to edema. There are several methods to control diabetic nephropathy: First, blood sugar and blood pressure must be strictly controlled within a normal range. Blood pressure control should be even stricter for those with diabetic nephropathy, generally kept below 130/80. Second, in terms of diet, it is crucial to avoid or limit intake of bean-based foods and consume high-quality proteins instead. High-quality proteins include commonly known meats, eggs, and fish. Third, it is essential to limit or avoid the use of medications that can damage the kidneys. Fourth, if diabetic nephropathy causes general body edema, intermittent use of diuretic medications can help alleviate the swelling, along with nephroprotective medications. The final method for severe kidney disease involves early intervention with hemodialysis or peritoneal dialysis. (Please use medications under the guidance of a doctor)