The early stages of diabetic nephropathy often show no obvious symptoms. Symptoms may not develop until 80 percent of the kidneys have been damaged, according to the American Diabetes Association. When symptoms do appear, they may include:

• Edema (swelling) of the ankles, other extremities, face and other parts of the body
• Fatigue
• High blood pressure
• Loss of appetite
• Unintentional weight loss or weight gain
• Excessive urination (polyuria)
• Excessive thirst (polydipsia)
• Vomiting
• Headache
• Hiccups
• Pruritus (generalized itching)

During the course of the disease, small amounts of protein (microalbuminuria) and then increasing amounts of protein will leak into the urine (proteinuria). The amount can be determined only through diagnostic testing.

Diabetic retinopathy is frequently present in patients with nephropathy at the time of diagnosis, because patients often have a long history of diabetes. Measures to control nephropathy (such as maintaining healthy blood pressure and glucose levels) may help control retinopathy as well.