Management of diabetic nephropathy

Abstract

The number of patients with end-stage renal failure due to diabetic nephropathy has been increasing year by year in Japan and accounted for more than 20% of those who were introduced to hemodialysis treatment in 1986. Although the disease is known to progress relentlessly and shows hardly any response to any form of conventional treatment, recent progress in techniques for the early detection of diabetic nephropathy has made it possible to suppress or retard the process leading to later overt nephropathy. Some new compounds for correcting the metabolic or hemodynamic alterations arising from hyperglycemia have been reported in preliminary clinical trials to improve glomerular functional alteration. Since the outcome of various treatments in patients with advanced diabetic nephropathy still remains gloomy, it should be stressed that early detection of renal alteration in diabetics and the correction of metabolic or hemodynamic derangements ought to be started without delay in the early stage of diabetic nephropathy.