Introduction to Pathogenetic Mechanisms of Diabetic Nephropathy

Abstract

Hyperglycemia has classically been identified as the principal factor in the pathogenesis and progression of diabetic nephropathy. Hyperglycemia induces renal damage directly but also through hemodynamic alterations. Because it has been noted that not all hyperglycemic diabetes patients will develop diabetic nephropathy, other factors contributing to the pathogenesis of the disease, e.g., genetic predisposition, hypertension, dyslipidemia, and proteinuria, have been identified. This chapter describes in brief the prevailing pathogenetic factors involved in the development and progression of diabetic nephropathy and serves as an overview of the chapters of Section II in which a detailed description of each individual component in the pathogenesis of the disease is discussed. A comprehensive understanding of each underlying mechanisms and downstream pathways as well as cross talks between these mechanisms is mandatory to development of novel therapeutic options.