title: Present and future in the treatment of diabetic kidney disease.
abstract: Diabetic kidney disease is the leading cause of end-stage renal disease. Albuminuria is recognized as the most important prognostic factor for chronic kidney disease progression. For this reason, blockade of renin-angiotensin system remains the main recommended strategy, with either angiotensin converting enzyme inhibitors or angiotensin II receptor blockers. However, other antiproteinuric treatments have begun to be studied, such as direct renin inhibitors or aldosterone blockers. Beyond antiproteinuric treatments, other drugs such as pentoxifylline or bardoxolone have yielded conflicting results. Finally, alternative pathogenic pathways are being explored, and emerging therapies including antifibrotic agents, endothelin receptor antagonists, or transcription factors show promising results. The aim of this review is to explain the advances in newer agents to treat diabetic kidney disease, along with the background of the renin-angiotensin system blockade.
authors.affiliation: Nephrology Unit, Hospital Universitario de Guadalajara, Spain.
authors.forename: Borja
authors.identifier: 0000-0001-5730-1929
authors.initials: B
authors.lastname: Quiroga
authors.affiliation: Nephrology Unit, Hospital Universitari Arnau de Vilanova, Lleida, Spain.
authors.forename: David
authors.identifier: 0000-0003-4652-0311
authors.initials: D
authors.lastname: Arroyo
authors.affiliation: Nephrology Unit, Hospital Universitario de Guadalajara, Spain ; Medicine and Medicine Specialities Department, Universidad de Alcalá (UAH), Madrid, Spain.
authors.forename: Gabriel
authors.initials: G
authors.lastname: de Arriba
mesh_terms: D000419:Albuminuria / Q000188:drug therapy* / Q000503:physiopathology; D057911:Angiotensin Receptor Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D003928:Diabetic Nephropathies / Q000188:drug therapy* / Q000503:physiopathology; D018450:Disease Progression; D006801:Humans; D011379:Prognosis; D012084:Renin-Angiotensin System / Q000187:drug effects* / Q000502:physiology
chemical_list: D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors