Diabetic Kidney Disease: Challenges, Progress, and Possibilities.

Document Type

Article

Publication Date

12-7-2017

Publication Title

Clin J Am Soc Nephrol

Keywords

Diabetic Nephropathies; Disease Progression; Glomerular Filtration Rate; Humans; Hyperglycemia; Hypertension; Hypoglycemic Agents; Kidney Failure, Chronic; Risk Factors

Abstract

Diabetic kidney disease develops in approximately 40% of patients who are diabetic and is the leading cause of CKD worldwide. Although ESRD may be the most recognizable consequence of diabetic kidney disease, the majority of patients actually die from cardiovascular diseases and infections before needing kidney replacement therapy. The natural history of diabetic kidney disease includes glomerular hyperfiltration, progressive albuminuria, declining GFR, and ultimately, ESRD. Metabolic changes associated with diabetes lead to glomerular hypertrophy, glomerulosclerosis, and tubulointerstitial inflammation and fibrosis. Despite current therapies, there is large residual risk of diabetic kidney disease onset and progression. Therefore, widespread innovation is urgently needed to improve health outcomes for patients with diabetic kidney disease. Achieving this goal will require characterization of new biomarkers, designing clinical trials that evaluate clinically pertinent end points, and development of therapeutic agents targeting kidney-specific disease mechanisms (

Clinical Institute

Kidney & Diabetes

Department

Nephrology

Department

Endocrinology

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