Slowing the Progression of Diabetic Nephropathy

Nephropathy, characterized by proteinuria and a decreasing glomerular filtration rate, develops in about 35 percent of patients with insulin-dependent diabetes mellitus1. The risk of death for patients with nephropathy is nine times that of diabetic patients without this complication. Renal disease in diabetes is predictably progressive in that the glomerular filtration rate declines linearly, at a rate of about 1 ml per minute per month. Thus, most patients reach end-stage renal failure within 10 years after the onset of proteinuria. The problem is so extensive that one third of new dialysis patients in the United States have diabetic nephropathy. . . .