Abstract
Diabetic nephropathy is the leading cause of end-stage renal disease in the United States. The progression of kidney disease in patients with diabetes can take many years, and interventions such as glycemic control, blood pressure control, and inhibition of the renin-angiotensin-aldosterone system have been shown to slow this progression. Despite the implementation of these strategies, the number of patients with diabetes that ultimately develop end-stage renal disease remains high. Recent investigation has focused on the optimization of renin-angiotensin-aldosterone system blockade in patients with diabetic nephropathy using combinations of drugs that target this pathway. Additional investigation has focused on the potential of novel therapies that either target various pathways upregulated by hyperglycemia or other targets believed to promote progression of diabetic nephropathy such as the endothelin system, inflammation and vitamin D receptors. This review article addresses some of the well-established principles regarding the progression and accepted management of diabetic nephropathy and includes current updates on the most recent clinical research trials exploring novel therapeutics in this field.
Keywords: Diabetes, Diabetic Nephropathy, Renin-Angiotensin-Aldosterone System, Hypertension, Endothelin-1, Albuminuria
Current Diabetes Reviews
Title:Current Update in the Management of Diabetic Nephropathy
Volume: 9 Issue: 1
Author(s): Peter Noel Van Buren and Robert Toto
Affiliation:
Keywords: Diabetes, Diabetic Nephropathy, Renin-Angiotensin-Aldosterone System, Hypertension, Endothelin-1, Albuminuria
Abstract: Diabetic nephropathy is the leading cause of end-stage renal disease in the United States. The progression of kidney disease in patients with diabetes can take many years, and interventions such as glycemic control, blood pressure control, and inhibition of the renin-angiotensin-aldosterone system have been shown to slow this progression. Despite the implementation of these strategies, the number of patients with diabetes that ultimately develop end-stage renal disease remains high. Recent investigation has focused on the optimization of renin-angiotensin-aldosterone system blockade in patients with diabetic nephropathy using combinations of drugs that target this pathway. Additional investigation has focused on the potential of novel therapies that either target various pathways upregulated by hyperglycemia or other targets believed to promote progression of diabetic nephropathy such as the endothelin system, inflammation and vitamin D receptors. This review article addresses some of the well-established principles regarding the progression and accepted management of diabetic nephropathy and includes current updates on the most recent clinical research trials exploring novel therapeutics in this field.
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Cite this article as:
Noel Van Buren Peter and Toto Robert, Current Update in the Management of Diabetic Nephropathy, Current Diabetes Reviews 2013; 9 (1) . https://dx.doi.org/10.2174/1573399811309010062
DOI https://dx.doi.org/10.2174/1573399811309010062 |
Print ISSN 1573-3998 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6417 |
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