International Journal For Multidisciplinary Research

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Diabetic Nephropathy: Pathogenesis, Clinical Features, and Emerging Therapeutic Strategies

Author(s) Ms. Gayathri Paturi, Mr. Arghadeep Sarkar, Dr. Bandi Veda Theja, Ms. Harshini Raja, Ms. Karothu Rohini, Prof. Dr. Raja Shekar Perusomula
Country India
Abstract Diabetic nephropathy (DN), also referred to as diabetic kidney disease (DKD), is a serious microvascular complication of diabetes mellitus and a leading cause of end-stage renal disease (ESRD) worldwide. It is marked by persistent albuminuria, a progressive decline in glomerular filtration rate (GFR), and elevated blood pressure. With the increasing global prevalence of diabetes, DN presents a major public health concern. Its pathogenesis involves hyperglycemia-induced metabolic disturbances, oxidative stress, inflammation, and fibrosis. Hemodynamic alterations, including intraglomerular hypertension and activation of the renin-angiotensin-aldosterone system (RAAS), further contribute to renal damage. Histological changes include mesangial expansion, thickening of the glomerular basement membrane, glomerulosclerosis, and tubulointerstitial fibrosis. Clinically, DN advances through five stages, from hyperfiltration to ESRD. Prognosis is influenced by glycemic control, blood pressure, genetic factors, and comorbidities. Diagnosis relies on the urinary albumin-to-creatinine ratio and estimated GFR. Management includes controlling blood glucose and blood pressure, lipid regulation, dietary changes, and RAAS inhibitors. Emerging treatments, such as SGLT2 inhibitors, finerenone, and anti-fibrotic agents, show promise. DN is linked to serious complications, especially cardiovascular disease, which remains the primary cause of death in affected patients.
Keywords Diabetic nephropathy, End-stage renal disease, Hyperglycemia, RAAS, SGLT2 inhibitors.
Published In Volume 7, Issue 4, July-August 2025
Published On 2025-07-03
DOI https://doi.org/10.36948/ijfmr.2025.v07i04.49726
Short DOI https://doi.org/g9r7px
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