Diabetic nephropathy is the number one cause of kidney failure. Almost a third of people with diabetes develop diabetic nephropathy. People with diabetes and kidney disease do worse overall than people with kidney disease alone. This is because people with diabetes tend to have other long-standing medical conditions, like high blood pressure, high cholesterol, and blood vessel disease (atherosclerosis).People with diabetes also are more likely to have other kidney-related problems, such as bladder infections and nerve damage to the bladder. Kidney disease in type 1 diabetes is slightly different than in type 2 diabetes. In type 1 diabetes, kidney disease rarely begins in the first 10 years after diagnosis of diabetes. In type 2 diabetes, some patients already have kidney disease by the time they are diagnosed with diabetes.