Diagnosis and treatment of early renal disease in patients with type 2 diabetes mellitus

What are the clinical needs?

Johannes F E Mann, Peter Rossing, Andrzej Wiȩcek, L. Rosivall, Patrick Mark, Gert Mayer

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Renal disease is prevalent in patients with diabetes mellitus type 2. Aggressive metabolic control and lowering of systemic and/or intraglomerular blood pressure are effective interventions but not without side effects. Thus a better, early identification of patients at risk for incidence or progression to end-stage renal failure by the use of new, validated biomarkers is highly desirable. In the majority of patients, hypertension and hyperglycaemia are pathogenetically important pathways for the progression of renal disease. Nonetheless even aggressive therapy targeting these factors does not eliminate the risk of end-stage renal failure and experimental evidence suggests that many other pathways (e.g. tubulointerstitial hypoxia or inflammation etc.) also contribute. As their individual importance might vary from patient to patient, interventions which interfere are likely not to be therapeutically effective in all subjects. In this situation, an option to preserve the statistical power of clinical trials is to rely on biomarkers that reflect individual pathophysiology. In current clinical practice, albuminuria is the biomarker that has been best evaluated to guide stratified/personalized therapy but there is a clear need to expand our diagnostic abilities.

Original languageEnglish
Pages (from-to)iv1-iv5
JournalNephrology Dialysis Transplantation
Volume30
DOIs
Publication statusPublished - Jan 12 2015

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Type 2 Diabetes Mellitus
Kidney
Biomarkers
Chronic Kidney Failure
Therapeutics
Albuminuria
Hyperglycemia
Disease Progression
Clinical Trials
Blood Pressure
Hypertension
Inflammation
Incidence

Keywords

  • diabetes mellitus type 2
  • innovative trial design
  • predictive biomarker
  • prognostic biomarker
  • renal disease

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

Cite this

Diagnosis and treatment of early renal disease in patients with type 2 diabetes mellitus : What are the clinical needs? / Mann, Johannes F E; Rossing, Peter; Wiȩcek, Andrzej; Rosivall, L.; Mark, Patrick; Mayer, Gert.

In: Nephrology Dialysis Transplantation, Vol. 30, 12.01.2015, p. iv1-iv5.

Research output: Contribution to journalArticle

Mann, Johannes F E ; Rossing, Peter ; Wiȩcek, Andrzej ; Rosivall, L. ; Mark, Patrick ; Mayer, Gert. / Diagnosis and treatment of early renal disease in patients with type 2 diabetes mellitus : What are the clinical needs?. In: Nephrology Dialysis Transplantation. 2015 ; Vol. 30. pp. iv1-iv5.
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