a. Symptoms of Diabetic Nephropathy——Cramping in the calf.

　　Patients with long-term diabetic nephropathy, if they appear the symptoms of cramp or calcium deficiency, it may reflect that that their kidneys have been damaged. Kidney secretes a kind of hormone which can regulate the metabolism of calcium and phosphorus. When patients progress to chronic kidney insufficiency, the reduction of parathyroid hormone release will cause a barrier to the reabsorption of calcium, and lead to decreasing of serum calcium, which may lead to osteopenia, osteoporosis and bone fracture. 

　　b. Symptoms of Diabetic Nephropathy——Persistent Hypertension

　　Because aldosterone produced in the kidney contributes to elevated blood pressure, diabetic kidney disease will cause an increase in aldosterone levels, and lead to difficult to control hypertension.

　　c. Symptoms of Diabetic Nephropathy——Stomach discomfort associated with anemia

　　If patients with diabetic nephropathy show symptoms of continuous discomfort in stomach and anemia, they should undergo renal function lab  tests.  Patients with diabetic nephropathy cannot adequately filter out the metabolic toxins, which may lead to uremic gastroenteritis with the symptoms of stomach discomfort and nausea. 

　　In order to detect Diabetic Nephropathy at its earliest stage, patients with diabetes for over 5 to 10 years should be seen by the kidney specialist, and baseline evaluation of kidney function, creatinine clearance, and proteinuria should be obtained.  When patients develop symptoms, such as leg calf cramping, gastrointestinal symptoms, or hypertension, they should undergo complete medical evaluation, paying particular attention to possible diabetic nephropathy.