Diabetic Kidney Disease: Future Directions

Abstract

While much progress has been made advancing our knowledge in the Pathogenetic mechanisms of diabetic kidney disease (DKD) including the role of oxidative stress, inflammation and fibrosis as eloquently presented (by N. Sharma, J. Lee and I.M. McFarlane) in chapter 6 of this volume, this progress has not been adequately translated into therapeutic modalities to aid clinicians handling the rapid rise of DKD that is associated with significant increase in morbidity and mortality in the USA and around the globe. For example, agents that block the renin angiotensin aldosterone system (RAAS) such as angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) are only effective in halting the progress of DKD in a minority of patients.

In this chapter we discuss the major therapeutic targets that are currently under investigations in clinical trials, highlighting the pathogenetic mechanisms and the therapeutic rationale for these potential interventions as future preventive and therapeutic strategies in DKD, a rapidly growing epidemic.

Keywords: Chronic kidney disease, Diabetes, Future directions, Nephropathy.

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