Pathogenic role of nitric oxide alterations in diabetic nephropathy

Diabetic nephropathy is the most frequent cause of terminal renal failure, requiring renal replacement therapy. Although a number of factors may contribute to the development of renal disease in diabetes, the recent past has witnessed an explosive growth in literature pertaining to the role of nitric oxide in diabetic nephropathy. However, there are significant controversies in the findings of these studies partly because of the complex metabolic pathways involved in the generation and fate of nitric oxide in the diabetic kidney. The following discussion presents a critical and balanced review of the current understanding of this subject.