What is the long-term effect of poorly managed diabetes on the kidneys?

Poorly managed diabetes can have significant long-term effects on the kidneys, primarily leading to diabetic nephropathy, which is a type of progressive kidney disease. High blood sugar levels over time can damage the blood vessels in the kidneys, reducing their ability to filter waste from the blood. This condition can progress to kidney failure, requiring dialysis or a kidney transplant.

Diabetic nephropathy is characterized by several changes within the kidneys, including increased protein in the urine, which is an early sign of kidney damage. As the condition advances, it can lead to further complications such as hypertension and the eventual deterioration of kidney function. Well-controlled diabetes, on the other hand, typically helps maintain kidney health, emphasizing the importance of effective diabetes management to prevent such complications.

In contrast to the correct answer, options relating to normal kidney function, increased kidney size, and decreased kidney filtration rate do not adequately describe the primary issue associated with long-term poor management of diabetes. While kidney size can sometimes increase early in diabetes due to hyperfiltration, this does not represent the end-stage outcome, which is the deterioration leading to nephropathy and potentially kidney failure.