Tight glycemic and blood pressure control, along with renin-angiotensin system inhibition, are crucial for preventing or delaying the progression of diabetic nephropathy.
Reinforces multifactorial risk reduction in diabetic nephropathy care; leaves open need for contemporary RCTs on optimal targets.
In Brief Diabetic nephropathy is the most common cause for end-stage renal disease and for patients entering into chronic dialysis care. It occurs in 25–40% of patients with diabetes. Risk factors include hyperglycemia,hypertension, genetic predisposition, glomerular hyperfiltration, proteinuria,the renal renin-angiotensin system, advanced glycation end-products, and possibly reduced nephron number and lipid disorders. Prevention of diabetic nephropathy is crucial. Tight control of diabetes, blood pressure treatment to systolic pressure of < 130 mmHg, reduction of proteinuria, and treatment with drugs that inhibit the renin-angiotensin system are all associated with prevention of or delay in progression of diabetic kidney injury.
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Phillip Hall (2006) studied this question.
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