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International Journal of Vascular Medicine
Volume 2011 (2011), Article ID 971524, 7 pages
Review Article

Vascular Homeostasis and Angiogenesis Determine Therapeutic Effectiveness in Type 2 Diabetes

Renal Microvascular Research Group, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand

Received 22 January 2011; Accepted 27 March 2011

Academic Editor: Sherif Sultan

Copyright © 2011 Narisa Futrakul and Prasit Futrakul. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Under common practice, recognition and treatment of type 2 diabetic nephropathy (DN) are usually revealed at a rather late stage (CKD stages 3–5) due to the insensitiveness of available diagnostic markers. Accumulating data obtained from vascular homeostasis in late stage DN demonstrated (1) a defective angiogenesis and impaired NO production which explains the therapeutic resistance to vasodilators and the inability to correct chronic renal ischemia and (2) an abnormally elevated antiangiogenesis and a progressive vascular disease which correlates with the altered renal hemodynamics characterized by a progressive reduction in renal perfusion as the disease severity progressed. In contract, the vascular homeostasis is adequately functional in early stage DN. Thus, vasodilator treatment at early stage DN (CKD stages 1-2) can enhance renal perfusion, correct the renal ischemia, and restore renal function.