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<div class="article-header" itemprop="headline"> <h1>Type 2 Diabetes and Kidney Disease (Nephropathy)</h1> </div> <p class="attribution" id="byline"> Written by Joann Jovinelly | Published on <meta content="2012-01-16" itemprop="datePublished"/>January 16, 2012<br/>Medically Reviewed by <a href="http://www.healthline.com/health/medical-board">Jason Baker, MD</a> on June 2, 2014</p> <div class="hl-widget-sharebar c"></div> <div class="sharebarContainer"><a class="link-sharebar" href="#overlaySharebar" id="sharebarLink" rel="#overlaySharebar"></a></div> <div class="dotted-line"></div> <div class="text-resize"> <a class="text1 selected" href="#text1" id="text1">A</a> <a class="text2" href="#text2" id="text2">A</a> <a class="text3" href="#text3" id="text3">A</a> </div> <div class="box-byblock-shadow"></div> </header> <div class="grid648"> <div id="fb-root"></div> <script>window.fbAsyncInit = function() { FB.init({ appId : '1529595680591919', xfbml : true, version : 'v2.1' }); }; (function(d, s, id){ var js, fjs = d.getElementsByTagName(s)[0]; if (d.getElementById(id)) {return;} js = d.createElement(s); js.id = id; js.src = "//connect.facebook.net/en_US/sdk.js"; fjs.parentNode.insertBefore(js, fjs); }(document, 'script', 'facebook-jssdk'));</script> <div class="container-article" itemscope="" itemtype="http://schema.org/Article"> <div class="textBlock c " id="toptoc-full-content"> <div class="article-body c" itemprop="articleBody"> <div class="box-img-thumbnail-article-container "> <div class="box-img-thumbnail-article"><img alt="Diabetic Nephropathy" class="img-thumbnail-article" itemprop="image" src="http://www.healthline.com/hlcmsresource/images/topic_centers/type-2-diabetes/article-images/194x105_diabetic_nephropathy.jpg"/></div> </div> <p>Nephropathy, or kidney disease, is among the most serious complications for many diabetics and the leading cause of kidney failure in the United States. According to the National Institutes of Health (NIH), there were more than 398,861 Americans with <A id="hllink14" class="hllink hllink-auto" href="http://www.healthline.com/health/end-stage-kidney-disease">end-stage kidney disease</A> living by means of <A id="hllink22" class="hllink hllink-auto" href="http://www.healthline.com/health/dialysis">dialysis</A> in 2009. Like other diseases associated with type 2 diabetes, nephropathy has few early symptoms or warning signs. Damage to the kidneys can occur for as long as a decade before the first symptoms even appear. </p> <p>According to Dr. Charles M. Clark, Jr. M.D., former chairman of the National Diabetes Education Program, “A person can have type 2 diabetes for 9 to 12 years before it’s discovered. During those years, harmful changes are already occurring, causing 5 to 10 percent to [already] have kidney disease at the time of diagnosis.” </p> <h2>Causes of Diabetic Nephropathy</h2> <p>There is no one specific cause for kidney disease, though experts believe its development is likely associated with years of uncontrolled <A id="hllink81" class="hllink hllink-auto" href="http://www.healthline.com/health/glucose-test-blood">blood glucose</A>. Other factors likely play important roles as well, such as genetic predisposition.</p> <p>The <A id="hllink35" class="hllink hllink-auto" href="http://www.healthline.com/human-body-maps/kidney">kidneys</A> are the body’s blood filtration system. Each is made up of hundreds of thousands of nephrons that “clean” the blood of waste. Over time, especially when a person is suffering from type 2 diabetes, the kidneys become overworked because they are constantly removing excess glucose from the blood. The nephrons become inflamed and scarred (sclerosis) and they no longer work as well.</p> <p>Soon, the nephrons can no longer fully filter the body’s blood supply. Material that would typically be removed from the blood, like protein, passes into the urine. Much of that unwanted material is a protein called albumin, the levels of which can be tested in a urine sample to help determine how your kidneys are functioning. A small amount of albumin in the urine is referred to as microalbuminuria; when larger amounts are found (macroalbuminuria), the dangers of <A id="hllink8" class="hllink hllink-auto" href="http://www.healthline.com/health/kidney-failure">kidney failure</A> are much greater. In those cases, end-stage renal disease (ESRD) is a risk and treatment is in the form of dialysis, or having your blood filtered by machine and pumped back into your body.</p> <h2><strong>Risk Factors for Diabetic Nephropathy</strong></h2> <p>If you already have type 2 diabetes, or have been told you are “prediabetic” (meaning that your blood glucose is borderline high, or that you possess known factors that put you at greater risk for developing the disease), your kidneys are already overworked and their function should be tested annually. Early diagnosis of kidney disease is essential for preserving good health. Besides diabetes, other risk factors for kidney disease are: </p> <ul> <li>uncontrolled <A id="hllink243" class="hllink hllink-auto" href="http://www.healthline.com/health/high-blood-pressure-hypertension">hypertension</A> (high blood pressure)</li> <li>uncontrolled hyperglycemia (high blood glucose)</li> <li>obesity</li> <li>high cholesterol</li> <li>family history of kidney disease</li> <li>family history of heart disease</li> <li>cigarette smoking</li> <li>advanced age</li> <li>race (African Americans, American Indians, Hispanic Americans, and Asian Americans show a higher prevalence of kidney disease) </li></ul> <p>Remember, there are often no symptoms of kidney disease until they are no longer functioning. Signs that your kidneys could be at risk include fluid retention and swelling in the <A id="hllink294" class="hllink hllink-auto" href="http://www.healthline.com/health/workplace-health/if-you-work-on-your-feet">feet</A>, <A id="hllink300" class="hllink hllink-auto" href="http://www.healthline.com/human-body-maps/ankle">ankles</A>, and legs, a poor appetite, feeling exhausted and weak most of the time, frequent <A id="hllink308" class="hllink hllink-auto" href="http://www.healthline.com/health/headache">headaches</A>, upset stomach, nausea, and <A id="hllink311" class="hllink hllink-auto" href="http://www.healthline.com/health/vomiting">vomiting</A>. Other signs include <A id="hllink315" class="hllink hllink-auto" href="http://www.healthline.com/health/insomnia">insomnia</A> and difficulty concentrating.   </p> <h2>Preventing Diabetic Nephropathy</h2> <p>The best way to preserve kidney health is to carefully <strong>watch your diet</strong>. Diabetics with partial kidney function need to be even more vigilant about maintaining healthy blood glucose, blood cholesterol, and lipid levels.</p> <p>Maintaining a blood pressure of less than 130/80 is also essential. Even if you have mild kidney disease, it may be made much worse by hypertension. To help <strong>lower your blood pressure</strong>, eat foods low in salt, don’t add <A id="hllink342" class="hllink hllink-auto" href="http://www.healthline.com/health/sodium-chloride">salt</A> to meals, <A id="hllink349" class="hllink hllink-auto" href="http://www.healthline.com/health/diet-and-weight-loss-fitness-exercise">lose weight</A>, and avoid alcohol. Based on your doctor’s recommendations, daily <A id="hllink350" class="hllink hllink-auto" href="http://www.healthline.com/health/fitness-exercise">exercise</A> is also a must. Most type 2 diabetics with hypertension take ACE inhibitors like captopril and enalapril, drugs that also have the potential to slow the progression of kidney disease. Doctors also commonly prescribe angiotensin receptor blockers, or ARBs.</p> <p><strong>If you smoke cigarettes, you should stop immediately</strong>. According to a 2011 report from the National Institute of Health, cigarette smoking is now an established risk factor for developing kidney disease.</p><p> Your doctor may also recommend medications or for you to follow a low-fat, low-protein diet.</p></div> <div class="box-pagination c"> <ul class="list-pagination c"> <li class="list-item-pagi" id="btn-previous-page"> <a class="anchor-pagi" href="#"><img alt="Previous page button" class="icon-list-item-pagi" height="14" src="http://www.healthline.com/resources/healthline/images/pagi-prev-big.v1.20141209121224.png" width="9"/></a> </li> <li class="list-item-pagi btn-page">1</li> <li class="list-item-pagi" id="btn-next-page"> <a class="anchor-pagi" href="#"><img alt="Next page button" class="icon-list-item-pagi" height="14" src="http://www.healthline.com/resources/healthline/images/pagi-next-big.v1.20141209121224.png" width="9"/></a> </li> </ul> </div> <div class="box-share-help-feedback c"> <div class="row12"> <div class="span5"> <div class="box-article-helpful"> <div class="box-helpful-question"> Was this article helpful? <span class="helpful-option-yes">Yes</span> <span class="helpful-option-no">No</span> </div> <div class="box-helpful-confirmation"></div> </div> </div> <div class="span3"> <div class="box-link-feedback"> <span class="icon-email"></span> <a class="link-feedback" href="#feedbackOverlay" id="feedbackLink" rel="#feedbackOverlay">Feedback?</a> </div> <div class="overlay-simple overlay-feedback" id="feedbackOverlay"> <div class="overlay-content"> <div class="box-form-feedback" id="feedbackformdiv"> <form action="/v2/widgetemail" id="feedbackform"> <input name="to" type="hidden" value="hrl"></input> <input id="urlfield" name="urlfield" type="hidden" value=""></input> <h2>Send us your feedback</h2> <p class="box-message">We are unable to respond directly to questions, but your feedback is greatly appreciated, and will be taken into account in our ongoing review of our Health Reference Library.<br/></p> <p> <label>Your Name:</label><br/> <input class="field-name" id="nametext" name="nametext" placeholder="Name Here" type="text"></input> <span class="box-msg-error" id="box-msg-name"><span class="icon-error">✖</span> <span id="errorMsgName">Please enter your name</span></span> </p> <p> <label>Your Email:</label><br/> <input class="field-email-address" id="feedbackemail" name="emailaddress" placeholder="name@example.com" type="email"></input> <span class="box-msg-error" id="box-msg-email"><span class="icon-error">✖</span> <span id="errorMsgEmail">Please enter your email</span></span> </p> <p> <input id="copy" name="copy" type="checkbox"></input> <label>Send me a copy</label> </p> <p class="box-textarea"> <textarea class="field-message" cols="60" id="feedbacktextarea" name="messagetext" rows="4"></textarea> </p> <div class="textarea-char-count" id="charcount">0</div> <p class="box-buttons"> <button class="btn-cancel" name="feedbackcancelbutton" type="button">Cancel</button> <button class="btn-send-msg">Send Message</button> <span class="box-loading"><img alt="" src="http://www.healthline.com/resources/base/images/ajax-loader.gif"/></span> </p> </form> <p class="box-privacy"><span class="icon-lock"></span> Email addresses will not be shared with 3rd parties. 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Please try again later.</p> </div> </div><div class="overlay-footer"> <div class="overlay-close">Close</div> </div> </div> </div> </div> </div> <div class="row12"> <div class="span12 hl-article-references"> <div class="hl-article-source"> <hr class="hl-references-line" style="width:100%;"/> <p class="hl-references-title"><a href="#"><span class="view-references-title">Show</span> Sources</a> <span class="hl-hide-show-icon hl-icon-down-arrow"></span></p> <div class="hl-references-body"> <div class="basesources"> <ul><li>American Diabetes Association. Diabetes Statistics. (2011) Data from the 2011 National Diabetes Fact Sheet. <em>National Diabetes Fact Sheet, 2011.</em> <a href="http://www.diabetes.org/diabetes-basics/diabetes-statistics/">http://www.diabetes.org/diabetes-basics/diabetes-statistics/</a></li><li>MedlinePlus Medical Encyclopedia. (2011) Diabetic Nephropathy. <a href="http://www.nlm.nih.gov/medlineplus/ency/article/000494.htm">http://www.nlm.nih.gov/medlineplus/ency/article/000494.htm</a></li><li>Charles Clark, M.D. et al. (2000) Promoting Early Diagnosis and Treatment of Type 2 Diabetes: The National Diabetes Education Program. <em>The Journal of American Medicine</em>. 284 (3): 363–365. <a href="http://jama.ama-assn.org/content/284/3/363.full.pdf+html?sid=227d196a-37d5-4494-ac6d-6e77434e3a6d">http://jama.ama-assn.org/content/284/3/363.full.pdf+html?sid=227d196a-37d5-4494-ac6d-6e77434e3a6d</a></li><li>Edgar A. James, M.D. (2011) Tobacco Smoke Enhances the Progression of Diabetic Nephropathy. National Institute of Environmental Health Sciences – National Institutes of Health. <a href="http://www.niehs.nih.gov/research/supported/sep/2011/tobacco-diabetes/index.cfm">http://www.niehs.nih.gov/research/supported/sep/2011/tobacco-diabetes/index.cfm</a> </li><li>National Institutes of Health. (2011) Advances and Emerging Opportunities in Diabetes Research: A Strategic Planning Report of the Diabetes Mellitus Interagency Coordinating Committee (DMICC). <em>DMICC Report</em>. <a href="http://www2.niddk.nih.gov/NR/rdonlyres/42B8D16A-ECEB-4AF4-B866-0EDA67E5B7BA/0/DRCR.net">http://www2.niddk.nih.gov/NR/rdonlyres/42B8D16A-ECEB-4AF4-B866-0EDA67E5B7BA/0/DRCR.net</a></li><li>National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC). Kidney Disease Statistics for the United States. Retrieved June 2, 2014 from <a href="http://kidney.niddk.nih.gov/KUDiseases/pubs/kustats/index.aspx">http://kidney.niddk.nih.gov/KUDiseases/pubs/kustats/index.aspx</a></li></ul></div> </div> </div><!-- end of article source block --> </div> </div><!-- row12 --> <div class="toc-content-promotion"> <!--hl-linking-ignore-start--> <div class="overlay-content-promotion"> <div class="content-promotion-header"> <div class="triangle"></div> <div class="content-promotion-title"> <p class="content-promotion-title-text">Trending Now</p> </div> <div class="content-promotion-close"><a class="link-close-overlay-content-promotion" href="#"></a></div> </div> <div class="content-promotion-stories"> <div class="content-promotion-story click-link" data="/health-slideshow/lifestyle-changes-help-manage-copd"> <div class="content-promotion-title">Lifestyle Changes to Help Manage COPD</div> <div class="content-promotion-image"> <a href="http://www.healthline.com/health-slideshow/lifestyle-changes-help-manage-copd" title="Lifestyle Changes to Help Manage COPD"><img alt="Lifestyle Changes to Help Manage COPD" src="http://www.healthline.com/hlcmsresource/images/slideshow/Lifestyle-changes-help-manage-copd/194x105_Lifestyle-Changes-to-Help-Manage-COPD.jpg"/></a> </div> <div class="content-promotion-text"> <div class="content-promotion-disclaimer">Leading a healthy lifestyle can make a big difference in your COPD symptoms. 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Healthline is for informational purposes and should not be considered medical advice, diagnosis or treatment recommendations. <a href="http://www.healthline.com/health/terms-of-use" rel="nofollow">Terms of Use</a> | <a href="http://www.healthline.com/health/privacy-policy" rel="nofollow">Privacy Policy</a></p></div> </div> </div> </div> </div> </div> </div><!-- hl-main-content --> </div><!-- hl-page --> <!-- Synvisc_HL_Survey --> <script type="text/javascript">// <![CDATA[ var ord = window.ord || Math.floor(Math.random() * 1e16); document.write('<script type="text/javascript" src="http://ad.doubleclick.net/N4788/adj/Synvisc_HL_Survey;sz=1x1;ord=' + ord + '?"><\/script>'); // ]]></script> <noscript> <a href="http://ad.doubleclick.net/N4788/jump/Synvisc_HL_Survey;sz=1x1;ord=[timestamp]?"> <img height="1" src="http://ad.doubleclick.net/N4788/ad/Synvisc_HL_Survey;sz=1x1;ord=[timestamp]?" width="1"/> </a> </noscript> <!-- Comscore Survey Script --> <script src="//siterecruit.comscore.com/sr/healthline/broker.js"></script> <!-- Insight Tracking Tag --> <div id="ttdUniversalPixelTagab5d2702cb4346dfbe31c5c61e126b4a"> <script src="https://js.adsrvr.org/up_loader.1.1.0.js" type="text/javascript"></script> <script type="text/javascript"> (function(global) { var universalPixelApi = new TTDUniversalPixelApi(); universalPixelApi.init("fcovtha", ["ihyjpsl"], "https://insight.adsrvr.org/track/up", "ttdUniversalPixelTagab5d2702cb4346dfbe31c5c61e126b4a"); })(this); </script> </div> <script> // are these global variables needed? // do they need to be global variables? microsoft_adunit_keywordhints = "Type 2 Diabetes and Kidney Disease Nephropathy "; u_microsoft_adunit_channelids = ""; microsoft_adunit_channelids = ""; // is this input field needed? document.write('<input id="msftChannelIds1" name="msftChannelIds1" type="hidden" value="'+microsoft_adunit_channelids+'">'); require(["jquery","base/dfpmanager","base/responsive-ads","matchmedia"],function($,AppDfpmanager,AppResponsiveAds){ // default - show LB ad on page load var isAdOnPageLoad = true; var breakpointsToHideAd = []; var breakpointsToHideAdByPageType = []; isAdOnPageLoad = AppResponsiveAds.getShowAdOnPageLoad("LB",breakpointsToHideAd,breakpointsToHideAdByPageType); var cfgDfpManager = { isAdOnPageLoad: isAdOnPageLoad, adshost : 'http://ads.healthline.com', logged_in : 'false', dfpAdSite : 'hn.us.hl.lc.x.x.x', btk1 : '', btk2 : '', kw : 'diabeticnephropathy,diabetic_nephropathy,3815099', k1 : 'diabeticnephropathy', k2 : 'urinarytract', k3 : 'health', pos : 'lb', ugc : 'false', ac : '', uac : '', akh : 'Type 2 Diabetes and Kidney Disease Nephropathy ', aks : '5000', env : '', msiteID : '', adTagPageUrl : encodeURIComponent('/health/type-2-diabetes/kidney-disease'), partner : 'www', pg_dart_site : 'hn.us.hl.lc.x.x.x', pg_dart_zone : 'diabeticnephropathy', pg_k2 : 'urinarytract', pHLID : '3815099', HLID : '3815099', visit_type : 'HCviewer',hctype : 'H40',lcmain : 'Type 2 Diabetes', yeildex : 'true', targetsrc : '' }; AppDfpmanager.lbIframeInit(cfgDfpManager); }); </script> <script> require(["healthline/header"], function(header){ header.setOptions({ isNews: false, isNewsChecked: false }); }); </script> <script> require(["jquery"], function( $ ){ $(document).ready(function() { $( '#box-health-tools' ).on( 'click', 'a', function(){ if( $( this ).text() == 'Doctor Search' ){ _gaq.push( [ 'hl._link', $( this ).attr( 'href' ) ] ); return !window._gat; } return true; }); }); }); </script> <script> require([ 'jquery', 'base/util/sharebar' ],function( $ ) { // todo: need to // - fix bug regarding HTML encoding, apostrophes, double quotes and question mark characters with page title data that is passed to facebook via the name parameter // - in FE, decode any HTML encoding in title data // - in FE, escape the page title data // - verify four uses cases: // - html encoding // - single quote // - double quote // - question mark $(document).ready(function() { var page_image; var customWidgets = new Array(); var stringWidget = "facebook,twitter,googleplus,email,print"; var isPrintFriendly = false; if( (typeof stringWidget) == "string" && stringWidget.length > 0) { customWidgets = stringWidget.split(','); } else{ customWidgets = stringWidget; } ShareBar.init({ iconSize: "medium", widgets: customWidgets, containerId: ".hl-widget-sharebar", facebookApiKey: "239371929577489", facebookRedirect: "http://www.healthline.com/v2/windowclose", page_url: HLSHAREBAR.page_url, page_title: HLSHAREBAR.page_title, isPrintFriendly: isPrintFriendly, page_description: (HLSHAREBAR.page_description ? HLSHAREBAR.page_description : ''), email_page_url: HLSHAREBAR.email_page_url, email_page_title: HLSHAREBAR.email_page_title //page_image: page_image }); }); }); </script> <script> require([ "base/title-area", "base/overlay" ], function( WidgetTitleArea, AppOverlay ){ WidgetTitleArea.initialize(); var onBeforeLoadFunc = function() { $('.hl-main-content').css('z-index','auto'); }; var cfgOverlay = { maskColor: '#555555', maskLoadSpeed: 200, maskOpacity: 0.5, maskZindex: 9999999, top: "center", left: "center", close: ".overlay-close", onBeforeLoad: onBeforeLoadFunc }; AppOverlay.initialize( cfgOverlay ); }); require([ "base/rwd/title-area" ], function( WidgetTitleAreaResponsive ){ WidgetTitleAreaResponsive.initialize({ pubDateExists: true, medReviewDateExists: true, medReviewedBy: 'Jason Baker, MD', reviewDate: 'June 2, 2014' }); }); </script> <script> require([ 'jquery' ], function( $ ){ // activate toggle for hide/show FB comments $(window).load(function() { if( $('.fb-view-comments-bar').length ) { $('.fb-view-comments-bar').click(function() { $('.fb-view-comments-bar').toggleClass( 'open' ); if( $('.fb-view-comments-bar').hasClass( 'open' ) ) { $('.fb-view-comments-bar span.fb-view-comments-arrow').removeClass( "hl-icon-right-solid-arrow" ).addClass('hl-icon-down-arrow'); $('#fb-view-count').hide(); } else { $('.fb-view-comments-bar span.fb-view-comments-arrow').removeClass( "hl-icon-down-arrow" ).addClass('hl-icon-right-solid-arrow'); $('#fb-view-count').show(); } if($('#fb-view-count').html() == ' ()') $('#fb-view-count').hide(); }); } }); }); </script> <script> require(["jquery","base/overlay","base/feedback"],function($,AppOverlay){ var onBeforeLoadFunc = function() { $('.hl-main-content').css('z-index','auto'); $('#feedbackformdiv').show(); }; var cfgOverlay = { selectorValue: 'feedbackOverlay', maskColor: '#555555', maskLoadSpeed: 200, maskOpacity: 0.5, maskZindex: 9999999, top: "center", left: "center", close: ".overlay-close", onBeforeLoad: onBeforeLoadFunc }; AppOverlay.initialize(cfgOverlay); }); </script> <script> require(['jquery', 'base/content-promotion-widget'],function($, AppContentPromotion){ var config = { contentPromotionParam: '', platformPageType: 'regularArticle' }; AppContentPromotion.initialize(config); }); </script> <script> require(['jquery', "base/dfpmanager", "base/responsive-ads"],function($, AppDfpmanager, AppResponsiveAds){ $(function() { // determine if wsl ad is shown on page load var isAdOnPageLoad = true, adRBTimeDelay = 300; var breakpointsToHideAd = []; var breakpointsToHideAdByPageType = []; breakpointsToHideAd = ['997','768','600','480','320']; isAdOnPageLoad = AppResponsiveAds.getShowAdOnPageLoad("WSL",breakpointsToHideAd,breakpointsToHideAdByPageType); // isHideWSLOnPageLoad: true isAdOnPageLoad = false; adRBTimeDelay = 0; var cfgDfpManager = { isAdOnPageLoad: isAdOnPageLoad, adshost : 'http://ads.healthline.com', dfpAdSite : 'hn.us.hl.lc.x.x.x', btk1 : '', btk2 : '', kw : 'diabeticnephropathy,diabetic_nephropathy,3815099', k1 : 'diabeticnephropathy', k2 : 'urinarytract', k3 : 'health', pos : 'wsl', ugc : 'false', ac : '', uac : '', akh : 'Type 2 Diabetes and Kidney Disease Nephropathy ', aks : '5000', env : '', msiteID : '', adTagPageUrl : encodeURIComponent('/health/type-2-diabetes/kidney-disease'), yeildex : 'true' , targetsrc : '' }; var wsltimeout = setTimeout(function() { AppDfpmanager.wslIframeInit(cfgDfpManager); var dfpAdBodyWSL = document.getElementById("DFPAD_WSL").innerHTML; var doneWSL = false; if (dfpAdBodyWSL.indexOf('817-grey.gif') > 1) { document.getElementById("ads-box-header-wsl1").style.display = "none"; } }, adRBTimeDelay); }); // dom ready }); </script> <script> u_microsoft_adunit_channelids = "" microsoft_adunit_channelids = ""; document.write('<input id="msftChannelIds1" name="msftChannelIds1" type="hidden" value="'+microsoft_adunit_channelids+'">'); require(['jquery',"base/dfpmanager","base/responsive-ads","matchmedia"],function($,AppDfpmanager,AppResponsiveAds){ // determine if mr1 ad is shown on page load var isAdOnPageLoad = true; var breakpointsToHideAd = []; var breakpointsToHideAdByPageType = []; isAdOnPageLoad = AppResponsiveAds.getShowAdOnPageLoad("MR1",breakpointsToHideAd,breakpointsToHideAdByPageType); var adSize = '300x250,300x600'; if(matchMedia('only screen and (max-width: 600px)').matches) { adSize = '300x50,300x250'; } var cfgDfpManager = { isAdOnPageLoad: isAdOnPageLoad, adshost : 'http://ads.healthline.com', adSize: adSize, dfpAdSite : 'hn.us.hl.lc.x.x.x', btk1 : '', btk2 : '', kw : 'diabeticnephropathy,diabetic_nephropathy,3815099', k1 : 'diabeticnephropathy', k2 : 'urinarytract', k3 : 'health', pos : 'mr1', ugc : 'false', ac : '', uac : '', akh : 'Type 2 Diabetes and Kidney Disease Nephropathy ', aks : '5000', env : '', msiteID : '', adTagPageUrl : encodeURIComponent('/health/type-2-diabetes/kidney-disease'), yeildex : 'true', targetsrc : '' }; var mr1timeout = setTimeout(function() { AppDfpmanager.mr1IframeInit(cfgDfpManager); }, 300); }); </script> <script> require(["jquery","base/dfpmanager","base/responsive-ads","matchmedia"],function($,AppDfpmanager,AppResponsiveAds){ $(function() { // determine if mr2 ad is shown on page load var isAdOnPageLoad = true; var breakpointsToHideAd = []; var breakpointsToHideAdByPageType = []; breakpointsToHideAd = ['997','768','600','480','320']; var isAdOnPageLoad = AppResponsiveAds.getShowAdOnPageLoad("MR2",breakpointsToHideAd,breakpointsToHideAdByPageType); var cfgDfpManager = { isAdOnPageLoad: isAdOnPageLoad, adshost : 'http://ads.healthline.com', dfpAdSite : 'hn.us.hl.lc.x.x.x', btk1 : '', btk2 : '', kw : 'diabeticnephropathy,diabetic_nephropathy,3815099', k1 : 'diabeticnephropathy', k2 : 'urinarytract', k3 : 'health', pos : 'mr2', ugc : 'false', ac : '', uac : '', env : '', msiteID : '', adTagPageUrl : encodeURIComponent('/health/type-2-diabetes/kidney-disease'), yeildex : 'true' , targetsrc : '' }; AppDfpmanager.mr2IframeInit(cfgDfpManager); }); // dom ready }); </script> <script> require( [ "jquery", "base/overlay" ], function( $, AppOverlay ) { var onBeforeLoadFunc = function() { $('.hl-main-content').css('z-index','auto'); $('#sitepopupdiv').show(); }; var cfgOverlay = { maskColor: '#555555', maskLoadSpeed: 200, maskOpacity: 0.5, maskZindex: 9999999, top: "center", left: "center", close: ".overlay-close", onBeforeLoad: onBeforeLoadFunc }; AppOverlay.initialize( cfgOverlay ); $(document).trigger( 'overlay_init' ); $(document).ready( function() { var idSitePopupLink = $( '#sitePopupLink' ); var overlayPageURI = encodeURI( "\u002fhealth\u002ftype\u002d2\u002ddiabetes\u002fkidney\u002ddisease" ); idSitePopupLink.click( function() { HL_ga_sendTrackEvent({ gaEventCategory : 'Any Page', gaEventAction : 'pop-up-overlay:', gaEventLabel : overlayPageURI }); }) }); }); </script> <script> require(['jquery', 'base/image-gallery', 'base/dfpmanager', 'base/overlay', 'require.dust!resources/base/js/templates/image-gallery', 'lib/dust-helpers-1.1.1', 'jquery-ui', 'j/jquery.cookie', 'lib/date'], function($, AppImageGallery, AppDfpManager, AppOverlay, ImageGalleryTemplate){ var configAdPositionsToHide; var addAdPosition = true; var pageAdPositionsToHide = ['wsr']; AppImageGallery.initialize({ imageGalleryName : '', adRBTimeDelay : 300, adPositionsToHide : pageAdPositionsToHide }); var onBeforeLoadFunction = function(){ $('.hl-main-content').css('z-index','auto'); $('#hlImageGallery').show(); }; var configOverlay = { maskColor: '#555555', maskLoadSpeed: 200, maskOpacity: 0.5, maskZindex: 9999999, top: 'center', left: 'center', close: '.overlay-close', onBeforeLoad: onBeforeLoadFunction }; AppOverlay.initialize(configOverlay); }); </script> <script> var isWslAdDisplayed = true; var isArticleHelpful = true; // check if adPositionsToHide from Config file is not empty for current partner // if true, then get values // then compare values to this page adPositionsToHide // - add new ones from config file to this page var configAdPositionsToHide; var addAdPosition = true; var pageAdPositionsToHide = ['wsr']; // page type specific ads to hide if( !isWslAdDisplayed ) { pageAdPositionsToHide.push('wsl'); } require([ 'base/article', 'base/overlay', 'base/article-common', 'matchmedia', 'jquery.ba-resize' ],function( AppArticle, AppOverlay, AppArticleCommon ){ var cfgOverlay = { maskColor: '#555555', maskLoadSpeed: 200, maskOpacity: 0.5, maskZindex: 9999999, top: "center", left: "center", close: ".overlay-close" }; AppOverlay.initialize(cfgOverlay); AppArticle.initialize({ isWslAdDisplayed: isWslAdDisplayed, isArticleHelpful: isArticleHelpful, articlePageUri: '/health/type-2-diabetes/kidney-disease', adRBTimeDelay : 300, adPositionsToHide : pageAdPositionsToHide, isNavigator: false }); AppArticleCommon.initialize(); var adRefresh = false, mr1RefreshTime = 4000, articleTitle = "Type 2 Diabetes and Kidney Disease (Nephropathy)", isBackToTop = false; adRefresh = true; require([ 'base/article-pagination-v3' ],function( AppArticlePagination ){ AppArticlePagination.initialize({ isPaginationOverride: false, adRBTimeDelay: 300, adPositionsToHide: pageAdPositionsToHide, adRefresh: adRefresh, mr1RefreshTime: mr1RefreshTime, rightRailNotSticky: false, articleTitle: articleTitle, isFbCommentsOn: false, isBackToTop: isBackToTop }); }); }); </script> <script> require([ 'base/rwd/article' ], function( AppArticleResponsive ){ var isTOCarticle = false; var isMsiteId = false; var isMoveMr2 = true, isReadMore = false; AppArticleResponsive.initialize({ adRBTimeDelay : 300, isTOCarticle : isTOCarticle, isMsiteId : isMsiteId, templateMerge : 'true', isNavigator: false, isMoveMr2: isMoveMr2, isReadMore: isReadMore }); }); </script> <script> require(['jquery',"base/dfpmanager","base/responsive-ads","matchmedia"],function($,AppDfpmanager,AppResponsiveAds){ $(function() { // determine if pb ad is shown on page load var isAdOnPageLoad = true; var breakpointsToHideAd = []; var breakpointsToHideAdByPageType = []; breakpointsToHideAd = ['600','480','320']; var isAdOnPageLoad = AppResponsiveAds.getShowAdOnPageLoad("PB",breakpointsToHideAd,breakpointsToHideAdByPageType); var cfgDfpManager = { isAdOnPageLoad: isAdOnPageLoad, adshost : 'http://ads.healthline.com', logged_in : 'false', dfpAdSite : 'hn.us.hl.lc.x.x.x', btk1 : '', btk2 : '', kw : 'diabeticnephropathy,diabetic_nephropathy,3815099', k1 : 'diabeticnephropathy', k2 : 'urinarytract', k3 : 'health', pos : 'lb', ugc : 'false', ac : '', uac : '', akh : '', aks : '5000', env : '', msiteID : '', adTagPageUrl : encodeURIComponent('/health/type-2-diabetes/kidney-disease'), partner : 'healthline', pg_dart_site : 'hn.us.hl.lc.x.x.x', pg_dart_zone : 'diabeticnephropathy', pg_k2 : 'urinarytract', pHLID : '3815099', HLID : '3815099', visit_type : 'HCviewer',hctype : 'H40',lcmain : 'Type 2 Diabetes', yeildex : 'true', targetsrc : '' }; var pbtimeout = setTimeout(function() { AppDfpmanager.pbIframeInit(cfgDfpManager); }, 300); }); // dom ready }); </script> <script> var HL_adBlankMonitor = function(cfg) { if(cfg.adBlankCodes.length > 0) { for(var i = 0; i < cfg.adBlankCodes.length; i++) { if (typeof HL_ga_sendTrackEvent === 'function') { HL_ga_sendTrackEvent({ gaEventCategory : 'Ad Display', gaEventAction : 'Blank Ad', gaEventLabel : 'adBlankCode=' + cfg.adBlankCodes[i] + '&adspot=' + cfg.adPosition + '&pageUrl=' + window.location.pathname }); } } } }; require(["base/util/visit-tracker"],function(AppVisitTracker){ AppVisitTracker.initialize(); }); </script> <script> require([ 'healthline/newsletter-signup' ], function( newsletterSignup ){ newsletterSignup.setConfig({ newsletterHost: 'newsletter.healthline.com' }); }); </script> <script> /* load module */ require(["healthline/footer"]); </script> </cript type="text/javascript>>