What is new in diabetic nephropathy during the last decade?

Abstract

In the last decade, several aspects with respect to pathogenesis, treatment, and prevention of diabetic nephropathy have emerged: the role of adipokines and hyperfiltration in the pathogenesis of diabetic nephropathy, the use of new biomarkers which may predict the progressive dysfunction of different parts of the nephron in patient with diabetes mellitus, and the most recent development of new antidiabetic drugs, which may exert potent and well-documented nephro- and cardioprotective effects. The most exciting positive effects have recently been obtained with SGLT 2 inhibitors—a new class of antidiabetic drug which inhibits the sodium–glucose cotransporter and increases glucose excretion by the kidneys—and glucagon-like peptide 1 (GLP-1) receptor agonists. Finally, the importance of new guidelines developed by KDIGO (Kidney Disease: Improving Global Outcomes) and ERBP/ERA-EDTA (European Renal Association—European Dialysis and Transport Association) for patients with diabetes mellitus and chronic kidney disease is presented.