Novel Drug Treatment for Diabetic Nephropathy

Diabetic nephropathy (DN) is the leading cause of end-stage renal disease. In addition to the renin pathway, certain bioactive molecules are involved in its pathogenesis. Strategies to interrupt pathophysiological pathways are on the horizon. Aliskiren, a renin inhibitor, blocks the first step in the renin pathway. Protein kinase C overexpression is blocked by ruboxistaurin. Pentoxifylline and m-TOR inhibitors are anti-inflammatory agents in the pathogenesis of diabetic nephropathy. Inhibitors of advanced glycation, oxidative stress, and plasminogen activator inhibitor-1 have proved useful in animal models of diabetic nephropathy. Avosentan, an endothelin antagonist, decreases urinary albumin. Such targeted therapies have opened up avenues for researchers to develop agents that can halt and may even reverse the progression of diabetic nephropathy.