There is no cure for diabetic nephropathy, but there are many steps that can be taken to slow the deterioration of kidney function. These include:

• Perform regular glucose monitoring and control glucose (blood sugar).

• Monitor blood pressure and keep it within a safe range for people with diabetes (under 130/80 mmHg).
  
  
• Lose excess weight.
  
  
• Quit smoking.
  
  
• Improve cholesterol levels. Kidney damage has been linked to elevated lipid levels. Kidney damage has been linked to elevated levels of LDL and insufficient HDL.
  
  
• Eat a healthy diet formulated to slow the speed of nephropathy. Patients may be advised to limit protein and sodium and to avoid alcohol and caffeine.

In addition, two types of blood pressure medications may be effective in treating diabetic nephropathy. Angiotensin-converting enzyme inhibitors (ACE inhibitors) have been found to help protect kidney function in people with type 1 diabetes, as well as helping to control blood pressure. Angiotensin II receptor blockers (ARBs) widen blood vessels to help lower blood pressure. The U.S. Food and Drug Administration has approved some of these drugs in the treatment of diabetic nephropathy. Sometimes a combination of ACE inhibitors and ARBs may be prescribed.

As the condition worsens, additional medications, such as calcium channel blockers or beta blockers, may be necessary to control blood pressure. In addition, diuretics may be prescribed to help flush water and sodium from the body.

Recent research has injected debate into the treatment of diabetic nephropathy and high blood pressure. Although ACE inhibitors and ARBs are generally considered to be highly desirable for treating hypertensive diabetic individuals due to kidney protection effects, other medicines that lower blood pressure (antihypertensives) may be equally effective. Individuals are advised to ask their physician about the best treatment for them.

In addition, scientists are developing potential drug treatments for diabetic nephropathy.

If damage becomes severe enough, patients may require either a kidney transplant or undergo dialysis treatment. Dialysis occurs in one of two forms:

• Hemodialysis.  A machine replaces the work of the kidneys by filtering blood. The cleaned blood is then returned to the body.
  
  
• Peritoneal dialysis. The lining of the patient’s abdomen (peritoneal membrane) is used as the filter. A catheter is surgically inserted through the wall of the abdomen, and a special dialysis solution is introduced into the abdominal cavity. This solution removes waste products and excess fluids from the bloodstream.

Patients who undergo dialysis typically need to have the procedure done three or more times a week. Dialysis treatments usually continue for life or until the patient receives a transplant. However, there have been infrequent cases of people with chronic kidney disease who regained enough kidney function to discontinue dialysis and survive.

A kidney transplant is usually more effective than dialysis. However, there are numerous factors that influence kidney transplants. The availability of and the waiting period for an appropriate kidney, the risks of rejection and the accompanying need to take anti-rejection drugs (immunosuppressives) permanently are all risks of transplantation. In addition, the new kidney will face the same strain the old ones did if glucose and blood pressure are not controlled.