The background history of diabetic nephropathy

Abstract

This chapter presents an overview of the background history of diabetic nephropathy. The discovery of diabetic renal disease was a gradual process and the definition of diabetic nephropathy has changed over time. Initial studies of renal biopsies, radioimmunoassay, and the concept of micro- and macroalbuminuria are highlighted, as well as the discovery of renin-angiotensin-aldosterone system (RAAS). Landmark trials focusing on how diabetic nephropathy could be improved using pharmacologic blockade of RAAS are reviewed. Diabetes is the most common cause of end-stage renal disease in Western countries, and trials that highlight the benefit of treating hyperglycemia are presented.