title: Evolution of treatment for diabetic nephropathy: historical progression from RAAS inhibition and onward.
abstract: The past 2 decades have brought rapid advances in treatment options for chronic kidney disease; however, even with the best treatment, the decline of renal function and progression to end-stage renal disease (ESRD) continues in a significant number of patients. The prognosis of patients with diabetes and ESRD is grim, with < 50% of patients surviving beyond 5 years after diagnosis. Therefore, early recognition and optimal use of available interventions are essential, and research into newer therapeutic targets is needed. This article will review recent advances in our understanding of renal pathophysiology, summarize the evidence to date supporting current treatment options for diabetic nephropathy, and highlight new options that lie on the horizon for the treatment of diabetic kidney disease.
authors: Division of Nephrology, Medical College of Wisconsin, Milwaukee, WI 53226, USA. ssblumen@mcw.edu
authors: Samuel S
authors: SS
authors: Blumenthal
mesh_terms: D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D003928:Diabetic Nephropathies / Q000188:drug therapy* / Q000378:metabolism; D017127:Glycation End Products, Advanced / Q000037:antagonists & inhibitors; D006801:Humans; D007676:Kidney Failure, Chronic / Q000188:drug therapy* / Q000378:metabolism; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use*; D018384:Oxidative Stress; D012084:Renin-Angiotensin System / Q000187:drug effects; D016212:Transforming Growth Factor beta / Q000378:metabolism
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D017127:Glycation End Products, Advanced; D000451:Mineralocorticoid Receptor Antagonists; D016212:Transforming Growth Factor beta