Updates in the management of diabetic nephropathy

Jai Prakash
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引用次数: 2

Abstract

Diabetic nephropathy is the most frequent cause of end stage renal disease (ESRD) worldwide. Current treatments consisting of glycaemic and blood pressure control, and efficient anti-proteinuric effects of RAS blockade are not sufficient to prevent progression of ESRD in a substantial proportion of patients. This finding is consistent with the hypothesis that key pathogenic mechanisms leading to progression of renal disease in diabetic patients are not modified or inactivated by current therapeutic approaches. Despite extensive research in molecular signalling mechanism and a number of high-profile clinical trials of potentially nephroprotective agents, the pathogenetic mechanisms underlying the diabetic nephropathy are not fully understood. Currently, only one trial (atrasentan) that seems to have a potentially renoprotective effect is underway. Further research into the potential nephroprotective effects of novel glucose lowering agents is needed.

糖尿病肾病治疗的最新进展
糖尿病肾病是终末期肾病(ESRD)最常见的病因。目前的治疗方法包括控制血糖和血压,以及RAS阻断的有效抗蛋白尿作用,不足以防止相当一部分患者的ESRD进展。这一发现与导致糖尿病患者肾脏疾病进展的关键致病机制没有被当前的治疗方法改变或灭活的假设是一致的。尽管对分子信号机制进行了广泛的研究,并对潜在的肾保护药物进行了大量引人注目的临床试验,但糖尿病肾病的发病机制尚不完全清楚。目前,只有一项试验(阿特拉森坦)似乎具有潜在的肾脏保护作用,正在进行中。需要进一步研究新型降糖药的潜在肾保护作用。
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