This review highlights the importance of renin-angiotensin system blockade in managing diabetic nephropathy due to the convergence of genetic and environmental factors on the intrarenal renin system.
Supports RAS blockade in diabetic nephropathy; leaves open how intrarenal renin convergence guides personalized therapy.
Blockade of the renin-angiotensin system has become crucial in the management of type 1 (insulin-dependent) and type 2 (non-insulin-dependent) diabetes mellitus, especially in patients who are at risk of nephropathy. In this review, we address the issue of why the renin system and its blockade are so important. As in many complex processes, diabetic nephropathy reflects an interaction between genetic factors and environmental factors. Recent research has uncovered a number of environmental factors; control of these factors should contribute to improved management. The renin system is important in patients with diabetes mellitus because so many relevant factors converge on the intrarenal renin system.
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Norman K. Hollenberg (2006) studied this question.
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