Prevention of Progression in Diabetic Nephropathy

Prevention of Progression in Diabetic Nephropathy Phillip M. Hall , MD Abstract In Brief Diabetic nephropathy is the most common cause for end-stage renal disease and for patients entering into chronic dialysis care. It occurs in 25–40% of patients with diabetes. Risk factors include hyperglycemia, hypertension, genetic predisposition, glomerular hyperfiltration, proteinuria, the renal renin-angiotensin system, advanced glycation end-products, and possibly reduced nephron number and lipid disorders. Prevention of diabetic nephropathy is crucial. Tight control of diabetes, blood pressure treatment to systolic pressure of < 130 mmHg, reduction of proteinuria, and treatment with drugs that inhibit the renin-angiotensin system are all associated with prevention of or delay in progression of diabetic kidney injury. Footnotes Phillip M. Hall, MD, is a consultant in the Department of Nephrology and Hypertension at the Cleveland Clinic Foundation in Cleveland, Ohio. American Diabetes Association