Investigational drugs for diabetic nephropathy

Abstract

Background: Diabetic nephropathy is one of the main causes of end-stage renal disease (ESRD) and is associated with elevated cardiovascular morbidity and mortality. Objective: Current renoprotective treatments for diabetic nephropathy include strict glycemic and optimal blood pressure control, proteinuria/albuminuria reduction and the use of renin–angiotensin–aldosterone system (RAAS) blocking agents. However, the renoprotection provided by these treatments is only partial, calling for more effective approaches. Methods: This review examines emerging strategies for the treatment of diabetic nephropathy, including aggressive RAAS blockade, statins, glitazones, ruboxistaurin, and other promising agents. Results/conclusions: In diabetic patients with overt nephropathy, multipharmacological interventions represent a promising way to prevent progression to ESRD. Results of ongoing trials are needed to establish whether the current standard of care of diabetic nephropathy might be improved with these new strategies.

Keywords::

• chronic kidney disease
• diabetic nephropathy
• renin-angiotensin-aldosterone system
• renoprotective agents

Acknowledgements

Monica Cortinovis is a recipient of a fellowship from the ARMR (Association for Research on Rare Disease). The authors are sincerely grateful to the Foundation ART for Research on Transplantation Onlus for their continued support.