title: Diabetic nephropathy: where are we on the journey from pathophysiology to treatment?
abstract: Diabetic nephropathy affects 30-40% of people with diabetes, and is the leading cause of end-stage kidney disease. The current treatment paradigm relies on early detection, glycaemic control and tight blood pressure management with preferential use of renin-angiotensin system blockade. This strategy has transformed outcomes in diabetic kidney disease over the last 20 years. Over the last two decades we have also witnessed significant advances in the understanding of the pathophysiology of diabetic nephropathy; however, despite this new knowledge, we have yet to develop new treatments of proven efficacy. Whilst a continued emphasis on preclinical and clinical research is clearly needed, clinicians treating people with diabetes should not forget that, in the short term, the greatest gains are likely to be realised by more consistent deployment of existing therapies.
authors.affiliation: SW Thames Renal Unit, St Helier Hospital, Carshalton, Surrey, UK.
authors.forename: H
authors.initials: H
authors.lastname: Gallagher
authors.affiliation: SW Thames Renal Unit, St Helier Hospital, Carshalton, Surrey, UK.
authors.forename: R J
authors.initials: RJ
authors.lastname: Suckling
mesh_terms: D000328:Adult; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D003928:Diabetic Nephropathies / Q000209:etiology* / Q000628:therapy*; D016232:Endothelins / Q000037:antagonists & inhibitors / Q000502:physiology; D006801:Humans; D006943:Hyperglycemia / Q000150:complications / Q000628:therapy; D006973:Hypertension / Q000150:complications / Q000517:prevention & control; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000628:therapy; D017582:Renal Replacement Therapy / Q000639:trends; D012084:Renin-Angiotensin System / Q000502:physiology; D051247:Sodium-Glucose Transport Proteins / Q000037:antagonists & inhibitors / Q000502:physiology
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D016232:Endothelins; D051247:Sodium-Glucose Transport Proteins
keywords: diabetic nephropathy; glycaemic control