Recent advances in diabetic nephropathy

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Abstract
Diabetic nephropathy is the most common cause world-wide of renal failure requiring renal replacement therapy, most patients having type 2 rather than type 1 diabetes. Cardiovascular risk increases progressively as nephropathy develops. In addition to abnormalities in the glomerular endothelium and mesangium, recent data suggest that changes are also seen in the glomerular epithelial cell or podocyte. The foot processes of the podocyte broaden and efface and there is loss of podocyte specific proteins such as nephrin. Eventually there is loss of podocytes themselves. These changes may contribute to proteinuria.

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