期刊
KOREAN JOURNAL OF INTERNAL MEDICINE
卷 36, 期 4, 页码 753-766出版社
KOREAN ASSOC INTERNAL MEDICINE
DOI: 10.3904/kjim.2021.174
关键词
Diabetic nephropathies; Pathogenesis; Inflammation
资金
- Basic Science Research Program through the National Research Foundation of Korea - Ministry of Education [2018R1D1A1B05049016]
- National Research Foundation of Korea [2018R1D1A1B05049016] Funding Source: Korea Institute of Science & Technology Information (KISTI), National Science & Technology Information Service (NTIS)
Treatment of diabetic kidney disease faces unmet needs due to its complex pathophysiology and difficulty in treatment translation, requiring improved diagnostic tools to better distinguish subgroups. Chronic disease has not seen significant improvement in treatment.
Diabetic kidney disease (DKD) has been the leading cause of chronic kidney disease for over 20 years. Yet, over these two decades, the clinical approach to this condition has not much improved beyond the administration of glucose-lowering agents, renin-angiotensin-aldosterone system blockers for blood pressure control, and lipid-lowering agents. The proportion of diabetic patients who develop DKD and progress to end-stage renal disease has remained nearly the same. This unmet need for DKD treatment is caused by the complex pathophysiology of DKD, and the difficulty of translating treatment from bench to bed, which further adds to the growing argument that DKD is not a homogeneous disease. To better capture the full spectrum of DKD in our design of treatment regimens, we need improved diagnostic tools that can better distinguish the subgroups within the condition. For instance, DKD is typically placed in the broad category of a non-inflammatory kidney disease. However, genome-wide transcriptome analysis studies consistently indicate the inflammatory signaling pathway activation in DKD. This review will utilize human data in discussing the potential for redefining the role of inflammation in DKD. We also comment on the therapeutic potential of targeted anti-inflammatory therapy for DKD.
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