Pathogenetic Mechanisms of Diabetic Nephropathy

Diabetic nephropathy (DN) remains a major complication of diabetes leading to endstage renal disease (ESRD). The number of diabetic patients with ESRD who require renal replacement therapy has been increasing, implicating unsuccessful prevention of diabetic renal complication. This unfavorable outcome reflects insufficient knowledge on pathogenic mechanisms of DN and its detection at late stage. Currently, microalbuminuria is used for diagnosis of DN. However, some patients with microalbuminuria have advanced renal pathological changes indicating that microalbuminuria is not the perfect marker for early detection of DN and a better biomarker is urgently needed. Recently, particularly after the completion of the Human Genome Project, proteomics (systematic analysis of proteins for their identity, quantity and function) has been recognized as an emerging subdiscipline of modern sciences. During the past decade, proteomics has been widely applied to several areas of biomedical research, including the investigation of DN. This chapter summarizes recent progress of proteomics applied to DN with ultimate goals to better understand its pathogenic mechanisms and to search for novel biomarkers for earlier diagnosis. Copyright © 2011 S. Karger AG, Basel Despite appropriate treatment, diabetic nephropathy (DN) remains a major complication in diabetic patients and is the leading cause of endstage renal disease. This unfavorable outcome is most likely due to two main factors. First, the complexity of pathogenic mechanisms of DN is not well understood. Although several previous studies have been conducted to understand this diabetic renal complication, many pieces of the jigsaw of the entire image of its pathogenic mechanisms are still missing. It is not surprising that the prevention of this important diabetic complication is not so successful when this image remains D ow nl oa de d by : 54 .7 0. 40 .1 1 10 /6 /2 01 7 6: 16 :4 8 A M