특집 : 당뇨병성 신부전의 관리와 최신 치료 ; 당뇨병성 신증의 최신 치료 -새로운 약제를 중심으로-

Prevention, early detection, and treatment of renal disease in diabetic patients are becoming major healthcare issues. It is well known that hyperglycemia is a major risk factor for the development and progression of diabetic nephropathy. Therapeutic options such as strict glycemic control and early antihypertensive treatment effectively prevent or slow the progression of renal disease in both types of diabetes, depending on the clinical manifestations. The mainstay of diabetic nephropathy therapy is good glycemic control and maintaining optimal blood pressure with angiotensin converting enzyme (ACE) inhibitors and/or angiotensin receptor blockers (ARBs). Additionally, correction of dyslipidemia and cessation of smoking are additional important factors to prevent and slow the progression of diabetic nephropathy. Biochemical and hemodynamic hypotheses have been proposed and are supported by animal models as the principal causes of the development and progression of diabetic nephropathy. This review discusses new insights into the recent trend focusing on new therapies, including hemodynamic agents and biochemical agents for preventing and delaying the progression of diabetic nephropathy. (Korean J Med 77:686-694, 2009)