Diabetic Nephropathy

Abstract

Diabetic nephropathy is a leading cause of kidney disease but does not always lead to kidney failure. Genetic factors and age play a role in disease progression, but controllable factors such as diet, exercise, and lifestyle modification also affect progression. The emphasis should not only be to preserve kidney function because, in actuality, most diabetics never reach the end stages of kidney disease. The emphasis should be placed on preserving vascular integrity, mental function, and cardiac function. Newer therapies, such as SGLT2 inhibition, potassium sparing diuretics, and Nrf2 activators show promise in helping to manage the underlying mechanisms that define this disease. The cornerstone of therapy is still either angiotensin-converting enzyme inhibition or angiotensin-receptor blockade. Many of the mechanisms that worsen diabetes can be managed through diet and exercise, but control of one’s diet takes more than self-discipline; it takes knowledge and planning.