Early stage of vascular disease and diabetic kidney disease: an under-recognized entity

Abstract

Early stage of vascular disease and diabetic kidney disease (DKD stages 1 and 2) has been under-recognized, under common practice worldwide. The lack of sensitive diagnostic marker leads to late diagnosis and a progression of underlying vascular disease associated with chronic renal ischemia, which eventually intensifies the magnitude of DKD damage. Treatment at this late stage fails to correct the renal ischemia, or restore renal function, due to the altered vascular homeostasis associated with an impaired nitric oxide production. In contrast to the above information, early recognition of vascular disease and DKD with sensitive diagnostic markers would be able to implement an effective prevention of progression of vascular disease and DKD. Treatment at early stage under environment favorable for adequate vascular homeostasis is able to correct the renal ischemia and improve the renal function.

• Diabetic kidney disease
• diagnostic markers
• renal function
• renal ischemia
• vascular disease
• vascular homeostasis

Declaration of interest

We declare there is no conflict of interest in the content of this article. We appreciate the support of Thailand Research Fund, National Research Council Fund of Thailand, and the full support of Bhumirajanagarindra Kidney Institute and the Royal Society of Thailand to expand the therapeutic strategy of early prevention of DKD to the National level.