In the early stages of diabetic nephropathy, you would most likely not notice any signs or symptoms. In later stages, signs and symptoms may include: 
Worsening blood pressure control
Protein in the urine
Swelling of feet, ankles, hands or eyes
Increased need to urinate
Reduced need for insulin or diabetes medicine
Confusion or difficulty concentrating
Shortness of breath
Loss of appetite
Nausea and vomiting
Persistent itching
Fatigue
