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Diabetic nephropathy: What does the future hold?

R M Montero1, A Covic2, L Gnudi3

  • 1Renal, Dialysis and Transplantation Unit, Guy's and St Thomas' Hospital, London, UK. rosa_montero@hotmail.com.

International Urology and Nephrology
|October 7, 2015
PubMed
Summary
This summary is machine-generated.

Managing diabetic nephropathy (DN) requires controlling blood sugar, lipids, and blood pressure. While current therapies help, achieving remission is challenging, necessitating new biomarkers and treatment strategies for diabetic kidney disease.

Keywords:
AlbuminuriaAnti-fibroticsDiabetic nephropathyInflammationNew therapiesRAAS blockade

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Area of Science:

  • Nephrology
  • Endocrinology
  • Pharmacology

Background:

  • Current diabetic nephropathy (DN) management focuses on glycemic, lipid, and blood pressure control.
  • Renin-angiotensin-aldosterone system blockade is a primary therapy for overt DN, indicated by albuminuria or reduced glomerular filtration rate.
  • Intensive lifestyle interventions in specialized clinics showed promise for DN remission but are difficult to replicate in standard care.

Purpose of the Study:

  • To review the historical context and limitations of current diabetic nephropathy (DN) therapies.
  • To identify established and emerging clinical biomarkers for DN management.
  • To highlight challenges in defining and achieving remission, stability, and progression in DN.

Main Methods:

  • Literature review of landmark papers and expert opinions.
  • Extensive PubMed search for clinical biomarkers.
  • Analysis of therapeutic approaches and remission criteria in DN.

Main Results:

  • Current therapies for DN are effective once nephropathy is overt.
  • Specialized intensive management can slow DN progression but lacks broad clinical translation.
  • Numerous established and proposed biomarkers require further validation.

Conclusions:

  • Novel therapies for DN are urgently needed.
  • Re-evaluating definitions of remission, stability, and progression in DN is crucial for modern clinical practice.
  • Integrated approaches combining pharmacotherapy and intensive lifestyle management may offer future benefits for diabetic kidney disease.