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Journal of Diabetes Research
Volume 2015, Article ID 801348, 13 pages
http://dx.doi.org/10.1155/2015/801348
Review Article

Present and Future in the Treatment of Diabetic Kidney Disease

1Nephrology Unit, Hospital Universitario de Guadalajara, Spain
2Nephrology Unit, Hospital Universitari Arnau de Vilanova, Lleida, Spain
3Medicine and Medicine Specialities Department, Universidad de Alcalá (UAH), Madrid, Spain

Received 8 January 2015; Revised 26 March 2015; Accepted 27 March 2015

Academic Editor: Daisuke Koya

Copyright © 2015 Borja Quiroga et al. 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.

Abstract

Diabetic kidney disease is the leading cause of end-stage renal disease. Albuminuria is recognized as the most important prognostic factor for chronic kidney disease progression. For this reason, blockade of renin-angiotensin system remains the main recommended strategy, with either angiotensin converting enzyme inhibitors or angiotensin II receptor blockers. However, other antiproteinuric treatments have begun to be studied, such as direct renin inhibitors or aldosterone blockers. Beyond antiproteinuric treatments, other drugs such as pentoxifylline or bardoxolone have yielded conflicting results. Finally, alternative pathogenic pathways are being explored, and emerging therapies including antifibrotic agents, endothelin receptor antagonists, or transcription factors show promising results. The aim of this review is to explain the advances in newer agents to treat diabetic kidney disease, along with the background of the renin-angiotensin system blockade.