“Glomerular Disease in Focus: Distinguishing and Overlapping Mechanisms of Nephrotic Syndrome and Diabetic Nephropathy”

Nephrotic syndrome and diabetic nephropathy represent two of the most prevalent and clinically significant causes of chronic kidney disease worldwide. Nephrotic syndrome, defined by massive proteinuria (>3.5 g/day), hypalbuminaemia, oedema, and hyperlipidaemia, encompasses a spectrum of primary and secondary glomerulopathies. Diabetic nephropathy, the leading cause of end-stage renal disease globally, arises from complex interplay of haemodynamic, metabolic, and inflammatory mechanisms in the setting of diabetes mellitus. This review provides a detailed examination of the pathophysiology, clinical presentation, diagnostic approach, and current evidence-based management strategies for both conditions. We discuss the key histopathological features distinguishing the two entities, their shared risk factors, and emerging therapeutic targets including SGLT2 inhibitors, endothelin receptor antagonists, and mineralocorticoid receptor antagonists. Understanding these conditions is critical for nephrologists, endocrinologists, internists, and primary care physicians to improve patient outcomes and slow progression to end-stage renal disease.