Therapeutic interventions in nephropathy of IDDM

The pathophysiology of diabetic renal disease has been greatly clarified in recent years. A better understanding of its developmental stages has led to a series of therapeutic intervention trials. I describe the natural history of untreated insulin-dependent diabetes mellitus (IDDM) and the effects of various intervention modalities. Selected trials, some of them still in progress, are summarized, including studies of therapy with insulin, antihypertensives, and low-protein diets.