DIABeTIC NePhROPAThy: NOvel meChANISmS AND TheRAPIeS IN 2010

Diabetic nephropathy is the most common cause of end stage renal failure. In addition to renin pathway, other bioactive molecules are involved in its pathogenesis. Strategies to interrupt pathophysiological pathways are on the horizon. Aliskiren is the renin inhibitor, blocking the first step in renin pathway. Protein kinase C overexpression is blocked by ruboxistaurin. Pentoxifylline and m-TOR inhibitors are anti-inflammatory 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 would halt and rather may even reverse progression of diabetic nephropathy.