Pathogenesis of diabetic nephropathy

Diabetic nephropathy is the most important long-term complication of diabetes mellitus and is a major cause of end-stage renal disease. The condition is associated with excess cardiovascular morbidity and mortality, as well as other diabetic microvascular complications. The etiopathogenesis of diabetic nephropathy appears to involve both genetic and environmental factors leading to disease in a subgroup of patients. Improved knowledge of the natural history and pathophysiology of the condition have enabled therapeutic strategies to be employed that have improved the outlook for patients with nephropathy. Strategies aimed at the identification of patients at high risk of nephropathy could have a major impact on the overall cardiovascular and renal morbidity in diabetic patients. (C) 1996, Elsevier Science Inc.