Diabetic nephropathy: Pathophysiology, Staging, Prevalence, and Management

Abstract

Diabetes mellitus (DM) has become a significant economic burden because of high healthcare costs for the treatment and its related complications. Chronic hyperglycemia, affect severely our organ systems mainly, cardiovascular, nervous, and renal system. These diabetic complications can progress into morbidity and mortality. Diabetic nephropathy (DN) is a major cause of end-stage renal disease (ESRD) which affects 20–30% diabetic patients, characterized by sustained reduction in end glomerular filtration rate (GFR)and persistently high urinary albumin-to-creatinine ratio. Elevated glucose levels, high blood pressure long duration of diabetes, obesity, and dyslipidemia can increase the progression of DN. The pathophysiology of DN is mainly due to result of interactions between metabolic and hemodynamic pathways, which are often disrupted in diabetes. Pharmacological approaches for DN mainly include regulation of BP, control of blood sugar level, use of hypolipidemic agents, quitting smoking, diet control, and use of vitamin D receptor agonists. Hence, strategies of treatment like BP control and dyslipidemia control etc. are required to decrease the burden of DN and prevent its progression to end stage renal disease (ESRD). Keywords: Diabetes mellitus, Diabetic nephropathy, Hypertension, Dyslipidemia, Statins, End stage renal disease.