Have we reached the limits for the treatment of diabetic nephropathy?

Reza Hajhosseiny, Kaivan Khavandi, Naheed Jivraj, Soudeh Mashayekhi, David J. Goldsmith, Rayaz Malik

Research output: Contribution to journalReview article

11 Citations (Scopus)

Abstract

Introduction: The prevalence of diabetic nephropathy is increasing as a consequence of the global epidemic of diabetes, and the complications of diabetic nephropathy are unsurprisingly legion. Blockade of the renin-angiotensin-aldosterone system (RAAS) has formed the mainstay of management, but despite this, most individuals will suffer premature cardiovascular events, and many will progress to end-stage renal disease. Given the heterogeneity of pathologies, it is perhaps naïve to hope that blocking a single neurohormonal pathway will protect against the myriad of pathogenetic mechanisms that conspire to cause the injuries seen with diabetes. Chronic hyperglycaemia and resulting advanced glycation end products form a mechanistic axis, which appears central to many of the pathways that lead to diabetic nephropathy. Treatment with pyridoxamine (an inhibitor of advanced glycation end-products) may represent a strategy to counter these injurious pathways. Areas covered: In this review, the authors explore pyridoxamine and other emerging therapeutic agents in the battle against diabetic nephropathy. The authors also provide their perspectives on the field and potential future directions. Expert opinion: Although issues around validity of surrogate markers and clinical end points have complicated trial data in the field, currently available evidence is not persuasive as regards the clinical application of these agents. There remains a clear and growing need for emerging therapeutics to be used in combination with RAAS blocking agents.

Original languageEnglish
Pages (from-to)511-522
Number of pages12
JournalExpert Opinion on Investigational Drugs
Volume23
Issue number4
DOIs
Publication statusPublished - 2014
Externally publishedYes

Fingerprint

Diabetic Nephropathies
Pyridoxamine
Advanced Glycosylation End Products
Renin-Angiotensin System
Expert Testimony
Diabetes Complications
Hyperglycemia
Chronic Kidney Failure
Biomarkers
Pathology
Wounds and Injuries
Therapeutics

Keywords

  • Bardoxolone
  • Chronic kidney disease
  • Diabetic nephropathy
  • Pyridoxamine

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

Cite this

Have we reached the limits for the treatment of diabetic nephropathy? / Hajhosseiny, Reza; Khavandi, Kaivan; Jivraj, Naheed; Mashayekhi, Soudeh; Goldsmith, David J.; Malik, Rayaz.

In: Expert Opinion on Investigational Drugs, Vol. 23, No. 4, 2014, p. 511-522.

Research output: Contribution to journalReview article

Hajhosseiny, R, Khavandi, K, Jivraj, N, Mashayekhi, S, Goldsmith, DJ & Malik, R 2014, 'Have we reached the limits for the treatment of diabetic nephropathy?', Expert Opinion on Investigational Drugs, vol. 23, no. 4, pp. 511-522. https://doi.org/10.1517/13543784.2014.892580
Hajhosseiny, Reza ; Khavandi, Kaivan ; Jivraj, Naheed ; Mashayekhi, Soudeh ; Goldsmith, David J. ; Malik, Rayaz. / Have we reached the limits for the treatment of diabetic nephropathy?. In: Expert Opinion on Investigational Drugs. 2014 ; Vol. 23, No. 4. pp. 511-522.
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