Diabetic nephropathy. An update.

Nephropathy is a serious microvascular complication in patients with insulin-dependent diabetes mellitus. In the United States, diabetes accounts for one fourth of new cases of end-stage renal disease each year. Complication rates and costs are much higher for diabetic than for nondiabetic patients with end-stage renal disease. Despite numerous studies, the pathophysiology of diabetic renal disease is not completely understood. We reviewed the current status of the structural, functional, biochemical, pathogenetic, and treatment modalities of diabetic renal disease and examined future therapeutic interventions.