Diabetic nephropathy: implications for renal and cardiovascular outcomes.
Diabetic nephropathy is a disease entity that is becoming more prevalent in the developed world. Its effect on individuals and society is profound, both in terms of cost and on patient health, especially in relation to associated cardiovascular disease. This review is an analysis of the most recent data available on diabetic nephropathy and its clinical applications to patient care. Using Medline search for relevant data from 1983 to the present, it focuses on clinical strategies that are employed to help curtail the progressive nature of this disease. Current strategies, including glycemic control, blood pressure treatment, inhibition of the renin/angiotensin system, nutrition, and hyperlipidemia, are discussed in relation to the relevant clinical data. Current clinical markers and possible future treatments are also discussed in the context of aiming to improve clinical outcomes in patients who are affected.
The Heart Institute of Spokane, Spokane, WA, USA. folanl@intmedspokane.org
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Folan
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Tuttle
D000419:Albuminuria / Q000175:diagnosis; D000465:Algorithms; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D001786:Blood Glucose / Q000032:analysis; D002318:Cardiovascular Diseases / Q000191:economics / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D002986:Clinical Trials as Topic; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D003928:Diabetic Nephropathies / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000191:economics / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D006949:Hyperlipidemias / Q000188:drug therapy; D006973:Hypertension / Q000150:complications / Q000188:drug therapy; D008297:Male; D008403:Mass Screening; D009747:Nutritional Physiological Phenomena; D011379:Prognosis; D011507:Proteinuria / Q000175:diagnosis; D012084:Renin-Angiotensin System / Q000187:drug effects; D012306:Risk; D012307:Risk Factors; D013997:Time Factors
D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D001786:Blood Glucose