Diabetic Nephropathy: Pathogenesis and Management

Diabetic nephropathy (DN) is a major microvascular complication of diabetes mellitus and is the leading cause of end-stage renal disease (ESRD). Genetic, metabolic, systemic, and renal hemodynamic factors are involved in the pathogenesis of DN. Advanced glycation end products (AGEs), hypertension, oxidative stress, inflammation, and genetic susceptibility are risk factors for susceptibility to DN and its development. Management approaches of DN are based on the inhibitors of some components of the renin angiotensin aldosterone system (RAAS), AGEs, and protein kinase C (PKC) and combined antioxidants therapy with anti-inflammatory agents. The present review looks at some mechanisms involved in DN and its progression and also management approaches according to the inhibition of the risk factors of the disease.