How is proteinuric diabetic nephropathy caused by disturbed proteostasis and autophagy in podocytes?
Tharaux PL, Huber TB.
Progression of diabetic nephropathy (DN) is commonly defined by an increase in albuminuria from normoalbuminuria to microalbuminuria and from microalbuminuria to macroalbuminuria. Although many therapeutic interventions, including reducing hyperglycemia and intraglomerular pressure, have been shown to slow down the progression of DN, many patients still develop end-stage renal disease. A major difficulty in inducing remission in patients with early DN is the identification of biomarkers that could help to identify patients more likely to progress to end-stage renal disease. Traditional risk factors, such as albuminuria, do not effectively predict DN progression, and other predictors of DN have yet to be characterized and validated. The need for discovering sensitive and robust biomarkers to monitor the decline in renal function and to separate progressors from nonprogressors of DN is therefore of paramount importance.
