Diabetic nephropathy: a frontier for personalized medicine.
Authors Susztak K, Böttinger EP
Submitted By Erwin Bottinger on 2/8/2009
Status Published
Journal Journal of the American Society of Nephrology : JASN
Year 2006
Date Published 2/1/2006
Volume : Pages 17(2) : 361 - 367
PubMed Reference 16407421
Abstract Diabetic nephropathy (DNP) develops after latency periods that may vary by
several years in approximately one third of patients with diabetes. This
diabetic complication is a complex disorder whereby various genetic and
environmental factors determine susceptibility and progression to ESRD. Despite
rapid research progress, robust predictors to assess prospectively with high
precision the risk for DNP in individuals with diabetes are still lacking. Thus,
currently available therapies are usually initiated at more advanced stages of
DNP characterized by clinically overt manifestations, including increased
urinary albumin excretion and decreased glomerular filtration. In addition,
although these interventions have proven efficacy in slowing the progression of
DNP, they typically cannot prevent ESRD. New insights into the molecular
mechanisms that underlie the origin and progression of DNP are emerging rapidly
from advanced large-scale genetic and molecular studies in experimental models
and humans. Thus, genetic loci that confer risk for albuminuria and/or
progression of kidney disease associated with diabetes are being refined to
identify the relevant genetic variants in specific genes. Molecular mRNA
profiles that are obtained through microarray screens are being validated to
elucidate further their potential as molecular markers and to identify new
targets for novel preventive or therapeutic approaches aiming at curing DNP. The
challenge before the field is to translate the large amount of new genetic and
molecular data to empower clinicians and investigators with reliable predictors
of DNP for improved design of preventive clinical trials and for individualized
clinical management for millions of individuals affected by diabetes worldwide.

Investigators with authorship
Erwin BottingerMount Sinai School of Medicine