Investigational drugs for diabetic nephropathy

Expert Opin Investig Drugs. 2008 Oct;17(10):1487-500. doi: 10.1517/13543784.17.10.1487.

Abstract

Background: Diabetic nephropathy is one of the main causes of end-stage renal disease (ESRD) and is associated with elevated cardiovascular morbidity and mortality.

Objective: Current renoprotective treatments for diabetic nephropathy include strict glycemic and optimal blood pressure control, proteinuria/albuminuria reduction and the use of renin-angiotensin-aldosterone system (RAAS) blocking agents. However, the renoprotection provided by these treatments is only partial, calling for more effective approaches.

Methods: This review examines emerging strategies for the treatment of diabetic nephropathy, including aggressive RAAS blockade, statins, glitazones, ruboxistaurin, and other promising agents.

Results/conclusions: In diabetic patients with overt nephropathy, multipharmacological interventions represent a promising way to prevent progression to ESRD. Results of ongoing trials are needed to establish whether the current standard of care of diabetic nephropathy might be improved with these new strategies.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Aldehyde Reductase / antagonists & inhibitors
  • Angiotensin II Type 1 Receptor Blockers / therapeutic use
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Antibodies, Monoclonal / therapeutic use
  • Diabetic Nephropathies / drug therapy*
  • Diabetic Nephropathies / prevention & control
  • Drugs, Investigational / therapeutic use*
  • Dyslipidemias / drug therapy
  • Endothelin Receptor Antagonists
  • Glycosaminoglycans / therapeutic use
  • Humans
  • Hypertension / drug therapy
  • Hypoglycemic Agents / therapeutic use
  • Mineralocorticoid Receptor Antagonists
  • Protein Kinase C / antagonists & inhibitors
  • Renin / antagonists & inhibitors

Substances

  • Angiotensin II Type 1 Receptor Blockers
  • Angiotensin-Converting Enzyme Inhibitors
  • Antibodies, Monoclonal
  • Drugs, Investigational
  • Endothelin Receptor Antagonists
  • Glycosaminoglycans
  • Hypoglycemic Agents
  • Mineralocorticoid Receptor Antagonists
  • glucuronyl glucosamine glycan sulfate
  • Aldehyde Reductase
  • Protein Kinase C
  • Renin