Xue Rui, Gui Dingkun, Zheng Liyang, Zhai Ruonan, Wang Feng, Wang Niansong
Department of Nephrology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
J Diabetes Res. 2017;2017:1839809. doi: 10.1155/2017/1839809. Epub 2017 Mar 13.
Diabetic nephropathy (DN) is the most serious microvascular complication of diabetes and the largest single cause of end-stage renal disease (ESRD) in many developed countries. DN is also associated with an increased cardiovascular mortality. It occurs as a result of interaction between both genetic and environmental factors. Hyperglycemia, hypertension, and genetic predisposition are the major risk factors. However, the exact mechanisms of DN are unclear. Despite the benefits derived from strict control of glucose and blood pressure, as well as inhibition of renin-angiotensin-aldosterone system, many patients continue to enter into ESRD. Thus, there is urgent need for improving mechanistic understanding of DN and then developing new and effective therapeutic approaches to delay the progression of DN. This review focuses on recent progress and future perspective about mechanistic insight and management of DN. Some preclinical relevant studies are highlighted and new perspectives of traditional Chinese medicine (TCM) for delaying DN progression are discussed in detail. These findings strengthen the therapeutic rationale for TCM in the treatment of DN and also provide new insights into the development of novel drugs for the prevention of DN. However, feasibility and safety of these therapeutic approaches and the clinical applicability of TCM in human DN need to be further investigated.
糖尿病肾病（DN）是糖尿病最严重的微血管并发症，也是许多发达国家终末期肾病（ESRD）的最大单一病因。DN还与心血管疾病死亡率增加有关。它是遗传因素和环境因素相互作用的结果。高血糖、高血压和遗传易感性是主要危险因素。然而，DN的确切机制尚不清楚。尽管严格控制血糖和血压以及抑制肾素 - 血管紧张素 - 醛固酮系统有益，但许多患者仍会发展为ESRD。因此，迫切需要加深对DN机制的理解，进而开发新的有效治疗方法来延缓DN的进展。本综述重点关注DN机制洞察和管理方面的最新进展及未来展望。突出了一些临床前相关研究，并详细讨论了中医延缓DN进展的新观点。这些发现强化了中医治疗DN的理论依据，也为预防DN的新药开发提供了新见解。然而，这些治疗方法的可行性和安全性以及中医在人类DN中的临床适用性仍需进一步研究。
