In general, approximately one-third of patients with diabetes will develop chronic kidney disease. If early diagnosis and appropriate management are not achieved, some patients may progress to end-stage diabetic nephropathy and may ultimately require dialysis treatment.

The kidneys function as a highly specialized filtration system composed of numerous small blood vessels forming the glomeruli. The glomeruli act as filters, retaining essential nutrients in the blood while removing waste products and excess substances, which are then excreted from the body.

In the early stage of diabetic nephropathy, damage primarily occurs in the small blood vessels of the glomeruli. This leads to leakage of small amounts of protein into the urine (microalbuminuria). As the disease progresses, the kidneys gradually lose their ability to eliminate waste products from the blood, such as blood urea nitrogen (BUN) and creatinine, resulting in elevated levels in the bloodstream. An increase in serum creatinine is an important indicator of significant deterioration in renal function.

Hypertension is also a major risk factor for the development of diabetic nephropathy. Poorly controlled blood pressure in patients with diabetes increases the risk of kidney damage and accelerates disease progression. Hypertension can contribute to renal impairment, while declining kidney function can in turn further elevate blood pressure, creating a vicious cycle. Therefore, patients with diabetes should regularly monitor their blood pressure and seek medical treatment even for mild hypertension.