From pathophysiology to personalized care: A comprehensive review of diabetic kidney disease

Abstract

Diabetic kidney disease (DKD) stands as a prevalent and significant complication in individuals with type 2 diabetes, impacting nearly half of this population. It holds the primary position as the cause of chronic kidney disease and end-stage kidney disease globally, associated with heightened cardiovascular morbidity and mortality. Despite the array of available interventions to prevent and manage DKD, such as regulating blood sugar levels, controlling blood pressure, and inhibiting the renin-angiotensin system, numerous patients continue to grapple with the ongoing decline in kidney function and unfavorable outcomes. This comprehensive review offers an updated exploration of the pathophysiology, diagnosis, prevention, and treatment of DKD. Special attention is devoted to emerging treatment modalities displaying promising outcomes in clinical trials, notably sodium-glucose cotransporter 2 inhibitors, glucagon-like peptide 1 receptor agonists, non-steroidal mineralocorticoid receptor antagonists, and innovative agents addressing inflammation and fibrosis. The discourse also delves into the complexities and opportunities associated with integrating these therapies into clinical practice, emphasizing the necessity for personalized and all-encompassing care for DKD patients. The conclusion outlines future directions, urging further research and providing recommendations to advance both understanding and practical approaches in this domain.

Keywords

• pathophysiology
• personalized care
• diabetic kidney disease