PROGRESSION OF CHRONIC RENAL-DISEASE AND DIABETIC NEPHROPATHY - A REVIEW OF CLINICAL-STUDIES AND CURRENT THERAPY

Animal studies on the progression of chronic renal disease have limite d applicability to humans. However, human kidneys also progressively d eteriorate once they have suffered a certain degree of initial damage. Various therapeutic approaches to slowdown the progression of chronic renal disease [low-protein diets, angiotensin converting enzyme (ACE) inhibitors, etc.] seem promising. Large-scale, ongoing clinical studi es may offer definitive answers to their place in the management of pr ogressive renal disease. Diabetic nephropathy, the most common cause o f end-stage renal failure, follows a distinct course in insulin depend ent diabetes mellitus DM (IDDM); this is less well defined in non-insu lin dependent DM (NIDDM). Micro-albuminuria is an important hallmark o f early diabetic kidney disease, when it may still be amenable to ther apeutic interventions. Strict glycemic control, and ACE inhibitors may be beneficial in early stages of diabetic nephropathy. Less is known on use of calcium-channel blockers and low-protein diets in diabetic n ephropathy. There is also a paucity of information on management of di abetic nephropathy in type II DM.