The future of diabetic kidney disease management: what to expect from the experimental studies?

Diabetic kidney disease (DKD) is a major cause of end-stage renal disease. Intensive blood glucose and blood pressure control, particularly using inhibitors of the renin-angiotensin system, have long been mainstays of therapy in patients with DKD. Moreover, new anti-hyperglycemic drugs have recently...

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Bibliographic Details
Published in:Journal of nephrology 2020-12, Vol.33 (6), p.1151-1161
Main Authors: Barutta, Federica, Bellini, Stefania, Corbetta, Beatrice, Durazzo, Marilena, Gruden, Gabriella
Format: Article
Language:English
Subjects:
Medicine
Medicine & Public Health
Nephrology
Review
Urology
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Summary:Diabetic kidney disease (DKD) is a major cause of end-stage renal disease. Intensive blood glucose and blood pressure control, particularly using inhibitors of the renin-angiotensin system, have long been mainstays of therapy in patients with DKD. Moreover, new anti-hyperglycemic drugs have recently shown renoprotective effects and this represents a major progress in the management of DKD. However, the risk of progression is still substantial and additional drugs are required. Recent preclinical studies have identified novel therapeutic targets that may optimize renoprotection in the near future. Besides strategies aimed to reduce oxidative stress and inflammation in the kidney, novel extra-renal approaches targeting stem cells, extracellular vesicles, and the microbiota are on the horizon with promising preclinical data. Herein, we will review these lines of research and discuss potential clinical applications. Given the poor yield of experimental studies in DKD in the past years, we will also discuss strategies to improve translation of preclinical research to humans.
ISSN:1121-8428
1724-6059
DOI:10.1007/s40620-020-00724-1