Diabetic Kidney Disease: Challenges, Progress, and Possibilities.
Publication Title
Clin J Am Soc Nephrol
Document Type
Article
Publication Date
12-7-2017
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
Specialty/Research Institute
Nephrology
Specialty/Research Institute
Endocrinology
