Genes and diabetic nephropathy: what have we learnt so far?

$ Epidemiological evidence supports a role for genetic predisposition in the development of diabetic nephropathy. $ In the studies reviewed the strength of association between genetic factors and diabetic nephropathy in both type 1 and type 2 DM groups is weak. Larger, prospective studies are required. $ At present the role for genotype assessment in clinical practice is undened. However, family history of coronary artery disease, hypertension, renal disease or dyslipidaemia should be employed in risk assessment and in guiding high risk intervention strategy. $ The mainstay of management continues to be optimal glycaemic and blood pressure control, and treating dyslipidaemia in at risk individuals.