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Cardiology995 papers

Microalbuminuric diabetic nephropathy

Last edited: 4/23/2026

Overview

Microalbuminuric diabetic nephropathy is a progressive kidney disease characterized by increased urinary albumin excretion in patients with diabetes, preceding overt nephropathy and often indicating early renal damage 1725.

Diagnosis

  • Key Diagnostic Criteria: Elevated urinary albumin-to-creatinine ratio (ACR) typically defined as ≥30 mg/g 1725.
  • Recommended Tests: Regular monitoring of ACR, serum creatinine, estimated glomerular filtration rate (eGFR), and blood pressure 3725.
  • Grading: Staging based on ACR levels (normoalbuminuria, microalbuminuria, macroalbuminuria) and eGFR 725.
  • Management

  • First-Line Treatments:
  • - RAS Inhibition: Angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs) 6725. - Blood Pressure Control: Target <130/80 mmHg 3725.
  • Adjunctive Treatments:
  • - Metformin: When tolerated, to improve glycemic control 1. - Glucose Management: Intensive glycemic control to reduce albuminuria 7. - Statins: For dyslipidemia management 66. - Vitamin D Analogues: Paricalcitol shown to improve cardiovascular risk markers 29. - DPP-4 Inhibitors: Saxagliptin and vildagliptin reduce albuminuria independent of glycemic control 12.

    Special Populations

  • Pregnancy: Limited data; close monitoring of nephropathy progression is advised 4.
  • Elderly: Individualized treatment considering comorbidities and polypharmacy 8.
  • Comorbidities: Hypertension management critical; consider ACE inhibitors/ARBs for renoprotection 3625.
  • Key Recommendations

  • Initiate RAS inhibition with ACE inhibitors or ARBs for microalbuminuric diabetic nephropathy to reduce albuminuria and slow progression (Evidence: Strong 6725).
  • Maintain strict blood pressure control targeting <130/80 mmHg to mitigate renal damage (Evidence: Strong 3725).
  • Monitor urinary albumin-to-creatinine ratio regularly to assess disease progression and treatment efficacy (Evidence: Moderate 1725).
  • Consider vitamin D analogues like paricalcitol for additional cardiovascular risk reduction in patients with type 1 diabetes and diabetic nephropathy (Evidence: Moderate 29).
  • Use DPP-4 inhibitors such as saxagliptin or vildagliptin to further reduce albuminuria, independent of glycemic control (Evidence: Moderate 12).
  • References

    Showing 100 most recent of 311 indexed papers.

    1 Nayak SPRR, Pohokar P, Arasu MV, Soundharrajan L, Arockiaraj J. Gomisin A and metformin co-treatment attenuates diabetic nephropathy and cardiovascular dysfunction by modulating the AGE/RAGE pathway in a diabetic rat model. Molecular and cellular biochemistry 2026. link 2 Zheng Q, Qin X, Huang S, Yan Z, Liu J, Xiong Y et al.. The G9a-TRIM21 axis exacerbates diabetic renal ischemia-reperfusion injury by inducing methylation-dependent ubiquitination and degradation of FoxO3a to promote oxidative stress and pyroptosis. Redox biology 2026. link 3 Guo F, Qin L, Chen B, Xu H, Wang J, An R et al.. Predictive model combining blood pressure, glycemic and renal markers for diabetic nephropathy in elderly hypertensive patients with type 2 diabetes. Clinical and experimental hypertension (New York, N.Y. : 1993) 2025. link 4 Mimouni F, Khoury JC, Ehrlich S, Sheffer-Mimouni G, Rosenn B, Miodovnik M. Is Pregnancy a Risk Factor for Progression of Diabetic Retinopathy and Nephropathy in Type 1 Diabetes? A Matched Cohort Study. American journal of perinatology 2025. link 5 Xu C. Extra-adrenal aldosterone: a mini review focusing on the physiology and pathophysiology of intrarenal aldosterone. Endocrine 2024. link 6 Okuda Y, Ito S, Kashihara N, Shikata K, Nangaku M, Wada T et al.. The renoprotective effect of esaxerenone independent of blood pressure lowering: a post hoc mediation analysis of the ESAX-DN trial. Hypertension research : official journal of the Japanese Society of Hypertension 2023. link 7 Naaman SC, Bakris GL. Diabetic Nephropathy: Update on Pillars of Therapy Slowing Progression. Diabetes care 2023. link 8 Bell DSH. Combine and Conquer: With Type 2 Diabetes Polypharmacy Is Essential Not Only to Achieve Glycemic Control but Also to Treat the Comorbidities and Stabilize or Slow the Advancement of Diabetic Nephropathy. Journal of diabetes research 2022. link 9 Gharib AF, Askary AE, Almehmadi M, Etewa RL, Althobaiti BB, Allam HH et al.. Vitamin D and Hypoxia-Inducible Factor (HIF-1α) Serum Levels as Markers for Progression of Nephropathy in Type 2 Diabetic Patients. Clinical laboratory 2022. link 10 Wu J, Jiang C, Hua Y, Liu X, You C. Association between polymorphisms of cytokine genes and diabetic nephropathy: A comprehensive systematic review and meta-analysis. International journal of clinical practice 2021. link 11 Kim SK, Kim G, Choi BH, Ryu D, Ku SK, Kwak MK. Negative correlation of urinary miR-199a-3p level with ameliorating effects of sarpogrelate and cilostazol in hypertensive diabetic nephropathy. Biochemical pharmacology 2021. link 12 Mohsen M, Elberry AA, Mohamed Rabea A, Abdelrahim MEA, Hussein RRS. Saxagliptin and vildagliptin lowered albuminuria in patients with diabetes and hypertension independent on glycaemic control. International journal of clinical practice 2021. link 13 Li WH, Yin YM, Chen H, Rui ZR, Yuan Y, Yun H et al.. Clinical research on individualized hemodialysis preventing unconventional hypotension in diabetic nephropathy patient. The International journal of artificial organs 2020. link 14 Morimoto K, Matsui M, Samejima K, Kanki T, Nishimoto M, Tanabe K et al.. Renal arteriolar hyalinosis, not intimal thickening in large arteries, is associated with cardiovascular events in people with biopsy-proven diabetic nephropathy. Diabetic medicine : a journal of the British Diabetic Association 2020. link 15 Esfandiari A, Pourghassem Gargari B, Noshad H, Sarbakhsh P, Mobasseri M, Barzegari M et al.. The effects of vitamin D. Diabetes & metabolic syndrome 2019. link 16 Alnaggar ARLR, Sayed M, El-Deena KE, Gomaa M, Hamed Y. Evaluation of serum adiponectin levels in diabetic nephropathy. Diabetes & metabolic syndrome 2019. link 17 Komici K, Femminella GD, de Lucia C, Cannavo A, Bencivenga L, Corbi G et al.. Predisposing factors to heart failure in diabetic nephropathy: a look at the sympathetic nervous system hyperactivity. Aging clinical and experimental research 2019. link 18 Shamsaeefar A, Nikeghbalian S, Kazemi K, Mansorian M, Motazedian N, Malekhosseini SA. Kidney Transplant From a Deceased Donor With Renal Artery Aneurysm: A Case Report. Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation 2019. link 19 Yesil-Devecioglu T, Dayan A, Demirtunc R, Sardas S. Role of DNA repair genes XRCC3 and XRCC1 in predisposition to type 2 diabetes mellitus and diabetic nephropathy. Endocrinologia, diabetes y nutricion 2019. link 20 Liyanage P, Lekamwasam S, Weerarathna TP, Liyanage C. Effect of Vitamin D therapy on urinary albumin excretion, renal functions, and plasma renin among patients with diabetic nephropathy: A randomized, double-blind clinical trial. Journal of postgraduate medicine 2018. link 21 Roumeliotis AK, Roumeliotis SK, Panagoutsos SA, Tsetsos F, Georgitsi M, Manolopoulos V et al.. Association of ALOX12 gene polymorphism with all-cause and cardiovascular mortality in diabetic nephropathy. International urology and nephrology 2018. link 22 Jakhotia S, Sivaprasad M, Shalini T, Reddy PY, Viswanath K, Jakhotia K et al.. Circulating levels of Hsp27 in microvascular complications of diabetes: Prospects as a biomarker of diabetic nephropathy. Journal of diabetes and its complications 2018. link 23 da Silva Cristino Cordeiro V, de Bem GF, da Costa CA, Santos IB, de Carvalho LCRM, Ognibene DT et al.. Euterpe oleracea Mart. seed extract protects against renal injury in diabetic and spontaneously hypertensive rats: role of inflammation and oxidative stress. European journal of nutrition 2018. link 24 Takada T, Masaki T, Hoshiyama A, Toki T, Kamata Y, Shichiri M. Tolvaptan alleviates excessive fluid retention of nephrotic diabetic renal failure unresponsive to furosemide. Nephrology (Carlton, Vic.) 2018. link 25 Derakhshanian H, Shab-Bidar S, Speakman JR, Nadimi H, Djafarian K. Vitamin D and diabetic nephropathy: A systematic review and meta-analysis. Nutrition (Burbank, Los Angeles County, Calif.) 2015. link 26 Parving HH, Rossing P. Diabetic nephropathy in 2014: improved cardiorenal prognosis in diabetic nephropathy. Nature reviews. Nephrology 2015. link 27 Tessari P. Nitric oxide in the normal kidney and in patients with diabetic nephropathy. Journal of nephrology 2015. link 28 Gangadhariah MH, Luther JM, Garcia V, Paueksakon P, Zhang MZ, Hayward SW et al.. Hypertension is a major contributor to 20-hydroxyeicosatetraenoic acid-mediated kidney injury in diabetic nephropathy. Journal of the American Society of Nephrology : JASN 2015. link 29 Joergensen C, Tarnow L, Goetze JP, Rossing P. Vitamin D analogue therapy, cardiovascular risk and kidney function in people with Type 1 diabetes mellitus and diabetic nephropathy: a randomized trial. Diabetic medicine : a journal of the British Diabetic Association 2015. link 30 An Y, Xu F, Le W, Ge Y, Zhou M, Chen H et al.. Renal histologic changes and the outcome in patients with diabetic nephropathy. Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association 2015. link 31 Haghighatdoost F, Najafabadi MM, Bellissimo N, Azadbakht L. Association of dietary acid load with cardiovascular disease risk factors in patients with diabetic nephropathy. Nutrition (Burbank, Los Angeles County, Calif.) 2015. link 32 Holterman CE, Thibodeau JF, Towaij C, Gutsol A, Montezano AC, Parks RJ et al.. Nephropathy and elevated BP in mice with podocyte-specific NADPH oxidase 5 expression. Journal of the American Society of Nephrology : JASN 2014. link 33 Takao T, Matsuyama Y, Yanagisawa H, Kikuchi M, Kawazu S. Visit-to-visit variability in systolic blood pressure predicts development and progression of diabetic nephropathy, but not retinopathy, in patients with type 2 diabetes. Journal of diabetes and its complications 2014. link 34 Parati G, Liu X, Ochoa JE. Clinical relevance of visit-to-visit blood pressure variability: impact on renal outcomes. Journal of human hypertension 2014. link 35 Wada T, Haneda M, Furuichi K, Babazono T, Yokoyama H, Iseki K et al.. Clinical impact of albuminuria and glomerular filtration rate on renal and cardiovascular events, and all-cause mortality in Japanese patients with type 2 diabetes. Clinical and experimental nephrology 2014. link 36 Toyama T, Shimizu M, Furuichi K, Kaneko S, Wada T. Treatment and impact of dyslipidemia in diabetic nephropathy. Clinical and experimental nephrology 2014. link 37 Sato E, Nakamura T, Amaha M, Nomura M, Matsumura D, Yamagishi H et al.. Effect of tolvaptan in patients with chronic kidney disease due to diabetic nephropathy with heart failure. International heart journal 2014. link 38 Esparza-Martín N, Hernández-Betancor A, Suria-González S, Batista-García F, Braillard-Pocard P, Sánchez-Santana AY et al.. Serology for hepatitis B and C, HIV and syphilis in the initial evaluation of diabetes patients referred for an external nephrology consultation. Nefrologia : publicacion oficial de la Sociedad Espanola Nefrologia 2013. link 39 Gandhi S, Srinivasan B, Akarte AS. Aliskiren improves insulin resistance and ameliorates diabetic renal vascular complications in STZ-induced diabetic rats. Journal of the renin-angiotensin-aldosterone system : JRAAS 2013. link 40 Domingueti CP, Dusse LM, Carvalho Md, Gomes KB, Fernandes AP. Hypercoagulability and cardiovascular disease in diabetic nephropathy. Clinica chimica acta; international journal of clinical chemistry 2013. link 41 Aritomi S, Niinuma K, Ogawa T, Konda T, Nitta K. Additive effects of cilnidipine and angiotensin II receptor blocker in preventing the progression of diabetic nephropathy in diabetic spontaneously hypertensive rats. Clinical and experimental nephrology 2013. link 42 Mohamed RH, Abdel-Aziz HR, Abd El Motteleb DM, Abd El-Aziz TA. Effect of RAS inhibition on TGF-β, renal function and structure in experimentally induced diabetic hypertensive nephropathy rats. Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie 2013. link 43 Bonakdaran S, Hami M, Hatefi A. The effects of calcitriol on albuminuria in patients with type-2 diabetes mellitus. Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia 2012. link 44 Wada T, Shimizu M, Toyama T, Hara A, Kaneko S, Furuichi K. Clinical impact of albuminuria in diabetic nephropathy. Clinical and experimental nephrology 2012. link 45 Abdel-Rahman EM, Saadulla L, Reeves WB, Awad AS. Therapeutic modalities in diabetic nephropathy: standard and emerging approaches. Journal of general internal medicine 2012. link 46 Yi X, Xu L, Hiller S, Kim HS, Nickeleit V, James LR et al.. Reduced expression of lipoic acid synthase accelerates diabetic nephropathy. Journal of the American Society of Nephrology : JASN 2012. link 47 Conway BR, Rennie J, Bailey MA, Dunbar DR, Manning JR, Bellamy CO et al.. Hyperglycemia and renin-dependent hypertension synergize to model diabetic nephropathy. Journal of the American Society of Nephrology : JASN 2012. link 48 Magri CJ, Calleja N, Buhagiar G, Fava S, Vassallo J. Factors associated with diabetic nephropathy in subjects with proliferative retinopathy. International urology and nephrology 2012. link 49 Niu W, Qi Y. An updated meta-analysis of methylenetetrahydrofolate reductase gene 677C/T polymorphism with diabetic nephropathy and diabetic retinopathy. Diabetes research and clinical practice 2012. link 50 Packham DK, Alves TP, Dwyer JP, Atkins R, de Zeeuw D, Cooper M et al.. Relative incidence of ESRD versus cardiovascular mortality in proteinuric type 2 diabetes and nephropathy: results from the DIAMETRIC (Diabetes Mellitus Treatment for Renal Insufficiency Consortium) database. American journal of kidney diseases : the official journal of the National Kidney Foundation 2012. link 51 Zheng JM, Yao GH, Cheng Z, Wang R, Liu ZH. Pathogenic role of mast cells in the development of diabetic nephropathy: a study of patients at different stages of the disease. Diabetologia 2012. link 52 Sasso FC, Chiodini P, Carbonara O, De Nicola L, Conte G, Salvatore T et al.. High cardiovascular risk in patients with Type 2 diabetic nephropathy: the predictive role of albuminuria and glomerular filtration rate. The NID-2 Prospective Cohort Study. Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association 2012. link 53 Zheng W, Chen L. Factor analysis of diabetic nephropathy in Chinese patients. Diabetes & metabolic syndrome 2011. link 54 Navarro-González JF, Muros M, Mora-Fernández C, Herrera H, Meneses B, García J. Pentoxifylline for renoprotection in diabetic nephropathy: the PREDIAN study. Rationale and basal results. Journal of diabetes and its complications 2011. link 55 Nakagawa T, Tanabe K, Croker BP, Johnson RJ, Grant MB, Kosugi T et al.. Endothelial dysfunction as a potential contributor in diabetic nephropathy. Nature reviews. Nephrology 2011. link 56 Yeh HL, Huang LY, Su S, Yang MC, Wang TC. Underuse of ACE inhibitors and angiotensin II receptor blockers among patients with diabetic nephropathy in Taiwan. Health policy (Amsterdam, Netherlands) 2011. link 57 Nawroth PP, Isermann B. Mechanisms of diabetic nephropathy--old buddies and newcomers part 1. Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association 2010. link 58 Nawroth PP, Isermann B. Mechanisms of diabetic nephropathy--old buddies and newcomers part 2. Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association 2010. link 59 Park S, Bivona BJ, Kobori H, Seth DM, Chappell MC, Lazartigues E et al.. Major role for ACE-independent intrarenal ANG II formation in type II diabetes. American journal of physiology. Renal physiology 2010. link 60 Li H, Zheng X, Wang H, Zhang Y, Xin H, Chen X. XLF-III-43, a novel coumarin-aspirin compound, prevents diabetic nephropathy in rats via inhibiting advanced glycation end products. European journal of pharmacology 2010. link 61 Decoster T, Vermassen FE, Peeters PC, Hoste EA, De Waele JJ. Abdominal decompression for intra-abdominal hypertension after simultaneous pancreas-kidney transplantation. Clinical transplantation 2010. link 62 Salgado PP, Silva IN, Vieira EC, Simões e Silva AC. Risk factors for early onset of diabetic nephropathy in pediatric type 1 diabetes. Journal of pediatric endocrinology & metabolism : JPEM 2010. link 63 Burgess E. Reviewing the benefits of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers in diabetic nephropathy--are they drug specific or class specific?. The Canadian journal of cardiology 2010. link71169-7) 64 Mann JF, Green D, Jamerson K, Ruilope LM, Kuranoff SJ, Littke T et al.. Avosentan for overt diabetic nephropathy. Journal of the American Society of Nephrology : JASN 2010. link 65 Möllsten A, Jorsal A, Lajer M, Vionnet N, Tarnow L. The V16A polymorphism in SOD2 is associated with increased risk of diabetic nephropathy and cardiovascular disease in type 1 diabetes. Diabetologia 2009. link 66 Mallett C, House AA, Spence JD, Fenster A, Parraga G. Longitudinal ultrasound evaluation of carotid atherosclerosis in one, two and three dimensions. Ultrasound in medicine & biology 2009. link 67 Zhang D, Freedman BI, Flekac M, Santos E, Hicks PJ, Bowden DW et al.. Evaluation of genetic association and expression reduction of TRPC1 in the development of diabetic nephropathy. American journal of nephrology 2009. link 68 Mehdi UF, Adams-Huet B, Raskin P, Vega GL, Toto RD. Addition of angiotensin receptor blockade or mineralocorticoid antagonism to maximal angiotensin-converting enzyme inhibition in diabetic nephropathy. Journal of the American Society of Nephrology : JASN 2009. link 69 Schjoedt KJ, Astrup AS, Persson F, Frandsen E, Boomsma F, Rossing K et al.. Optimal dose of lisinopril for renoprotection in type 1 diabetic patients with diabetic nephropathy: a randomised crossover trial. Diabetologia 2009. link 70 Masulli M, Mancini M, Liuzzi R, Daniele S, Mainenti PP, Vergara E et al.. Measurement of the intrarenal arterial resistance index for the identification and prediction of diabetic nephropathy. Nutrition, metabolism, and cardiovascular diseases : NMCD 2009. link 71 Lin YL, Peng SJ, Ferng SH, Tzen CY, Yang CS. Clinical indicators which necessitate renal biopsy in type 2 diabetes mellitus patients with renal disease. International journal of clinical practice 2009. link 72 Ikeda H, Hamamoto Y, Honjo S, Nabe K, Wada Y, Koshiyama H. Olmesartan reduced microalbuminuria in Japanese subjects with type 2 diabetes. Diabetes research and clinical practice 2009. link 73 Devi P, George J. Drug information needs of physicians treating diabetic nephropathy in a tertiary care hospital. Kathmandu University medical journal (KUMJ) 2008. link 74 Lajer M, Tarnow L, Jorsal A, Teerlink T, Parving HH, Rossing P. Plasma concentration of asymmetric dimethylarginine (ADMA) predicts cardiovascular morbidity and mortality in type 1 diabetic patients with diabetic nephropathy. Diabetes care 2008. link 75 Le DS, Miles R, Savage PJ, Cornell E, Tracy RP, Knowler WC et al.. The association of plasma fibrinogen concentration with diabetic microvascular complications in young adults with early-onset of type 2 diabetes. Diabetes research and clinical practice 2008. link 76 Ohtomo S, Nangaku M, Izuhara Y, Takizawa S, Strihou Cv, Miyata T. Cobalt ameliorates renal injury in an obese, hypertensive type 2 diabetes rat model. Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association 2008. link 77 Silva JA. Evaluation and approach to treatment of renal artery stenosis in patients with diabetic nephropathy. Current diabetes reports 2008. link 78 Annemans L, Demarteau N, Hu S, Lee TJ, Morad Z, Supaporn T et al.. An Asian regional analysis of cost-effectiveness of early irbesartan treatment versus conventional antihypertensive, late amlodipine, and late irbesartan treatments in patients with type 2 diabetes, hypertension, and nephropathy. Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research 2008. link 79 Ko GJ, Kang YS, Lee MH, Song HK, Kim HK, Cha DR. Polymorphism of the aldosterone synthase gene is not associated with progression of diabetic nephropathy, but associated with hypertension in type 2 diabetic patients. Nephrology (Carlton, Vic.) 2008. link 80 Al-Kateb H, Boright AP, Mirea L, Xie X, Sutradhar R, Mowjoodi A et al.. Multiple superoxide dismutase 1/splicing factor serine alanine 15 variants are associated with the development and progression of diabetic nephropathy: the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Genetics study. Diabetes 2008. link 81 Thomaseth K, Pacini G, Morelli P, Tonolo G, Nosadini R. Importance of glycemic control on the course of glomerular filtration rate in type 2 diabetes with hypertension and microalbuminuria under tight blood pressure control. Nutrition, metabolism, and cardiovascular diseases : NMCD 2008. link 82 Najafian B, Franklin DB, Fogo AB. Acute renal failure and myalgia in a transplant patient. Journal of the American Society of Nephrology : JASN 2007. link 83 Alsaad KO, Herzenberg AM. Distinguishing diabetic nephropathy from other causes of glomerulosclerosis: an update. Journal of clinical pathology 2007. link 84 Shi YH, Zhao S, Wang C, Li Y, Duan HJ. Fluvastatin inhibits activation of JAK and STAT proteins in diabetic rat glomeruli and mesangial cells under high glucose conditions. Acta pharmacologica Sinica 2007. link 85 Yamamoto H, Watanabe T, Yamamoto Y, Yonekura H, Munesue S, Harashima A et al.. RAGE in diabetic nephropathy. Current molecular medicine 2007. link 86 Maione A, Nicolucci A, Craig JC, Tognoni G, Moschetta A, Palasciano G et al.. Protocol of the Long-term Impact of RAS Inhibition on Cardiorenal Outcomes (LIRICO) randomized trial. Journal of nephrology 2007. link 87 Ohtomo S, Izuhara Y, Takizawa S, Yamada N, Kakuta T, van Ypersele de Strihou C et al.. Thiazolidinediones provide better renoprotection than insulin in an obese, hypertensive type II diabetic rat model. Kidney international 2007. link 88 Hartner A, Cordasic N, Klanke B, Wittmann M, Veelken R, Hilgers KF. Renal injury in streptozotocin-diabetic Ren2-transgenic rats is mainly dependent on hypertension, not on diabetes. American journal of physiology. Renal physiology 2007. link 89 Oh YK, Joo KW, Lee JW, Jeon US, Lim CS, Han JS et al.. Altered renal sodium transporter expression in an animal model of type 2 diabetes mellitus. Journal of Korean medical science 2007. link 90 Griffin KA, Abu-Naser M, Abu-Amarah I, Picken M, Williamson GA, Bidani AK. Dynamic blood pressure load and nephropathy in the ZSF1 (fa/fa cp) model of type 2 diabetes. American journal of physiology. Renal physiology 2007. link 91 Ritz E. Anemia and diabetic nephropathy. Current diabetes reports 2006. link 92 Minutolo R, Sasso FC, Chiodini P, Cianciaruso B, Carbonara O, Zamboli P et al.. Management of cardiovascular risk factors in advanced type 2 diabetic nephropathy: a comparative analysis in nephrology, diabetology and primary care settings. Journal of hypertension 2006. link 93 Palmer AJ, Valentine WJ, Tucker DM, Ray JA, Roze S, Annemans L et al.. A French cost-consequence analysis of the renoprotective benefits of irbesartan in patients with type 2 diabetes and hypertension. Current medical research and opinion 2006. link 94 Ritz E. Diabetic nephropathy. Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia 2006. link 95 Sengul AM, Altuntas Y, Kürklü A, Aydin L. Beneficial effect of lisinopril plus telmisartan in patients with type 2 diabetes, microalbuminuria and hypertension. Diabetes research and clinical practice 2006. link 96 Vionnet N, Tregouët D, Kazeem G, Gut I, Groop PH, Tarnow L et al.. Analysis of 14 candidate genes for diabetic nephropathy on chromosome 3q in European populations: strongest evidence for association with a variant in the promoter region of the adiponectin gene. Diabetes 2006. link 97 Rossing P. Prediction, progression and prevention of diabetic nephropathy. The Minkowski Lecture 2005. Diabetologia 2006. link 98 Linden KC, DeHaan CL, Zhang Y, Glowacka S, Cox AJ, Kelly DJ et al.. Renal expression and localization of the facilitative glucose transporters GLUT1 and GLUT12 in animal models of hypertension and diabetic nephropathy. American journal of physiology. Renal physiology 2006. link 99 Ritz E, Haxsen V. Diabetic nephropathy and anaemia. European journal of clinical investigation 2005. link 100 Buranakitjaroen P, Deerochanawong C, Bunnag P. Microalbuminuria prevalence study (MAPS) in hypertensive patients with type 2 diabetes in Thailand. Journal of the Medical Association of Thailand = Chotmaihet thangphaet 2005. link

    Original source

    1. [1]
      Gomisin A and metformin co-treatment attenuates diabetic nephropathy and cardiovascular dysfunction by modulating the AGE/RAGE pathway in a diabetic rat model.Nayak SPRR, Pohokar P, Arasu MV, Soundharrajan L, Arockiaraj J Molecular and cellular biochemistry (2026)
    2. [2]
    3. [3]
      Predictive model combining blood pressure, glycemic and renal markers for diabetic nephropathy in elderly hypertensive patients with type 2 diabetes.Guo F, Qin L, Chen B, Xu H, Wang J, An R et al. Clinical and experimental hypertension (New York, N.Y. : 1993) (2025)
    4. [4]
      Is Pregnancy a Risk Factor for Progression of Diabetic Retinopathy and Nephropathy in Type 1 Diabetes? A Matched Cohort Study.Mimouni F, Khoury JC, Ehrlich S, Sheffer-Mimouni G, Rosenn B, Miodovnik M American journal of perinatology (2025)
    5. [5]
    6. [6]
      The renoprotective effect of esaxerenone independent of blood pressure lowering: a post hoc mediation analysis of the ESAX-DN trial.Okuda Y, Ito S, Kashihara N, Shikata K, Nangaku M, Wada T et al. Hypertension research : official journal of the Japanese Society of Hypertension (2023)
    7. [7]
    8. [8]
    9. [9]
      Vitamin D and Hypoxia-Inducible Factor (HIF-1α) Serum Levels as Markers for Progression of Nephropathy in Type 2 Diabetic Patients.Gharib AF, Askary AE, Almehmadi M, Etewa RL, Althobaiti BB, Allam HH et al. Clinical laboratory (2022)
    10. [10]
      Association between polymorphisms of cytokine genes and diabetic nephropathy: A comprehensive systematic review and meta-analysis.Wu J, Jiang C, Hua Y, Liu X, You C International journal of clinical practice (2021)
    11. [11]
    12. [12]
      Saxagliptin and vildagliptin lowered albuminuria in patients with diabetes and hypertension independent on glycaemic control.Mohsen M, Elberry AA, Mohamed Rabea A, Abdelrahim MEA, Hussein RRS International journal of clinical practice (2021)
    13. [13]
      Clinical research on individualized hemodialysis preventing unconventional hypotension in diabetic nephropathy patient.Li WH, Yin YM, Chen H, Rui ZR, Yuan Y, Yun H et al. The International journal of artificial organs (2020)
    14. [14]
      Renal arteriolar hyalinosis, not intimal thickening in large arteries, is associated with cardiovascular events in people with biopsy-proven diabetic nephropathy.Morimoto K, Matsui M, Samejima K, Kanki T, Nishimoto M, Tanabe K et al. Diabetic medicine : a journal of the British Diabetic Association (2020)
    15. [15]
      The effects of vitamin DEsfandiari A, Pourghassem Gargari B, Noshad H, Sarbakhsh P, Mobasseri M, Barzegari M et al. Diabetes & metabolic syndrome (2019)
    16. [16]
      Evaluation of serum adiponectin levels in diabetic nephropathy.Alnaggar ARLR, Sayed M, El-Deena KE, Gomaa M, Hamed Y Diabetes & metabolic syndrome (2019)
    17. [17]
      Predisposing factors to heart failure in diabetic nephropathy: a look at the sympathetic nervous system hyperactivity.Komici K, Femminella GD, de Lucia C, Cannavo A, Bencivenga L, Corbi G et al. Aging clinical and experimental research (2019)
    18. [18]
      Kidney Transplant From a Deceased Donor With Renal Artery Aneurysm: A Case Report.Shamsaeefar A, Nikeghbalian S, Kazemi K, Mansorian M, Motazedian N, Malekhosseini SA Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation (2019)
    19. [19]
      Role of DNA repair genes XRCC3 and XRCC1 in predisposition to type 2 diabetes mellitus and diabetic nephropathy.Yesil-Devecioglu T, Dayan A, Demirtunc R, Sardas S Endocrinologia, diabetes y nutricion (2019)
    20. [20]
    21. [21]
      Association of ALOX12 gene polymorphism with all-cause and cardiovascular mortality in diabetic nephropathy.Roumeliotis AK, Roumeliotis SK, Panagoutsos SA, Tsetsos F, Georgitsi M, Manolopoulos V et al. International urology and nephrology (2018)
    22. [22]
      Circulating levels of Hsp27 in microvascular complications of diabetes: Prospects as a biomarker of diabetic nephropathy.Jakhotia S, Sivaprasad M, Shalini T, Reddy PY, Viswanath K, Jakhotia K et al. Journal of diabetes and its complications (2018)
    23. [23]
      Euterpe oleracea Mart. seed extract protects against renal injury in diabetic and spontaneously hypertensive rats: role of inflammation and oxidative stress.da Silva Cristino Cordeiro V, de Bem GF, da Costa CA, Santos IB, de Carvalho LCRM, Ognibene DT et al. European journal of nutrition (2018)
    24. [24]
      Tolvaptan alleviates excessive fluid retention of nephrotic diabetic renal failure unresponsive to furosemide.Takada T, Masaki T, Hoshiyama A, Toki T, Kamata Y, Shichiri M Nephrology (Carlton, Vic.) (2018)
    25. [25]
      Vitamin D and diabetic nephropathy: A systematic review and meta-analysis.Derakhshanian H, Shab-Bidar S, Speakman JR, Nadimi H, Djafarian K Nutrition (Burbank, Los Angeles County, Calif.) (2015)
    26. [26]
      Diabetic nephropathy in 2014: improved cardiorenal prognosis in diabetic nephropathy.Parving HH, Rossing P Nature reviews. Nephrology (2015)
    27. [27]
    28. [28]
      Hypertension is a major contributor to 20-hydroxyeicosatetraenoic acid-mediated kidney injury in diabetic nephropathy.Gangadhariah MH, Luther JM, Garcia V, Paueksakon P, Zhang MZ, Hayward SW et al. Journal of the American Society of Nephrology : JASN (2015)
    29. [29]
      Vitamin D analogue therapy, cardiovascular risk and kidney function in people with Type 1 diabetes mellitus and diabetic nephropathy: a randomized trial.Joergensen C, Tarnow L, Goetze JP, Rossing P Diabetic medicine : a journal of the British Diabetic Association (2015)
    30. [30]
      Renal histologic changes and the outcome in patients with diabetic nephropathy.An Y, Xu F, Le W, Ge Y, Zhou M, Chen H et al. Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association (2015)
    31. [31]
      Association of dietary acid load with cardiovascular disease risk factors in patients with diabetic nephropathy.Haghighatdoost F, Najafabadi MM, Bellissimo N, Azadbakht L Nutrition (Burbank, Los Angeles County, Calif.) (2015)
    32. [32]
      Nephropathy and elevated BP in mice with podocyte-specific NADPH oxidase 5 expression.Holterman CE, Thibodeau JF, Towaij C, Gutsol A, Montezano AC, Parks RJ et al. Journal of the American Society of Nephrology : JASN (2014)
    33. [33]
    34. [34]
      Clinical relevance of visit-to-visit blood pressure variability: impact on renal outcomes.Parati G, Liu X, Ochoa JE Journal of human hypertension (2014)
    35. [35]
      Clinical impact of albuminuria and glomerular filtration rate on renal and cardiovascular events, and all-cause mortality in Japanese patients with type 2 diabetes.Wada T, Haneda M, Furuichi K, Babazono T, Yokoyama H, Iseki K et al. Clinical and experimental nephrology (2014)
    36. [36]
      Treatment and impact of dyslipidemia in diabetic nephropathy.Toyama T, Shimizu M, Furuichi K, Kaneko S, Wada T Clinical and experimental nephrology (2014)
    37. [37]
      Effect of tolvaptan in patients with chronic kidney disease due to diabetic nephropathy with heart failure.Sato E, Nakamura T, Amaha M, Nomura M, Matsumura D, Yamagishi H et al. International heart journal (2014)
    38. [38]
      Serology for hepatitis B and C, HIV and syphilis in the initial evaluation of diabetes patients referred for an external nephrology consultation.Esparza-Martín N, Hernández-Betancor A, Suria-González S, Batista-García F, Braillard-Pocard P, Sánchez-Santana AY et al. Nefrologia : publicacion oficial de la Sociedad Espanola Nefrologia (2013)
    39. [39]
      Aliskiren improves insulin resistance and ameliorates diabetic renal vascular complications in STZ-induced diabetic rats.Gandhi S, Srinivasan B, Akarte AS Journal of the renin-angiotensin-aldosterone system : JRAAS (2013)
    40. [40]
      Hypercoagulability and cardiovascular disease in diabetic nephropathy.Domingueti CP, Dusse LM, Carvalho Md, Gomes KB, Fernandes AP Clinica chimica acta; international journal of clinical chemistry (2013)
    41. [41]
    42. [42]
      Effect of RAS inhibition on TGF-β, renal function and structure in experimentally induced diabetic hypertensive nephropathy rats.Mohamed RH, Abdel-Aziz HR, Abd El Motteleb DM, Abd El-Aziz TA Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie (2013)
    43. [43]
      The effects of calcitriol on albuminuria in patients with type-2 diabetes mellitus.Bonakdaran S, Hami M, Hatefi A Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia (2012)
    44. [44]
      Clinical impact of albuminuria in diabetic nephropathy.Wada T, Shimizu M, Toyama T, Hara A, Kaneko S, Furuichi K Clinical and experimental nephrology (2012)
    45. [45]
      Therapeutic modalities in diabetic nephropathy: standard and emerging approaches.Abdel-Rahman EM, Saadulla L, Reeves WB, Awad AS Journal of general internal medicine (2012)
    46. [46]
      Reduced expression of lipoic acid synthase accelerates diabetic nephropathy.Yi X, Xu L, Hiller S, Kim HS, Nickeleit V, James LR et al. Journal of the American Society of Nephrology : JASN (2012)
    47. [47]
      Hyperglycemia and renin-dependent hypertension synergize to model diabetic nephropathy.Conway BR, Rennie J, Bailey MA, Dunbar DR, Manning JR, Bellamy CO et al. Journal of the American Society of Nephrology : JASN (2012)
    48. [48]
      Factors associated with diabetic nephropathy in subjects with proliferative retinopathy.Magri CJ, Calleja N, Buhagiar G, Fava S, Vassallo J International urology and nephrology (2012)
    49. [49]
    50. [50]
      Relative incidence of ESRD versus cardiovascular mortality in proteinuric type 2 diabetes and nephropathy: results from the DIAMETRIC (Diabetes Mellitus Treatment for Renal Insufficiency Consortium) database.Packham DK, Alves TP, Dwyer JP, Atkins R, de Zeeuw D, Cooper M et al. American journal of kidney diseases : the official journal of the National Kidney Foundation (2012)
    51. [51]
    52. [52]
      High cardiovascular risk in patients with Type 2 diabetic nephropathy: the predictive role of albuminuria and glomerular filtration rate. The NID-2 Prospective Cohort Study.Sasso FC, Chiodini P, Carbonara O, De Nicola L, Conte G, Salvatore T et al. Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association (2012)
    53. [53]
      Factor analysis of diabetic nephropathy in Chinese patients.Zheng W, Chen L Diabetes & metabolic syndrome (2011)
    54. [54]
      Pentoxifylline for renoprotection in diabetic nephropathy: the PREDIAN study. Rationale and basal results.Navarro-González JF, Muros M, Mora-Fernández C, Herrera H, Meneses B, García J Journal of diabetes and its complications (2011)
    55. [55]
      Endothelial dysfunction as a potential contributor in diabetic nephropathy.Nakagawa T, Tanabe K, Croker BP, Johnson RJ, Grant MB, Kosugi T et al. Nature reviews. Nephrology (2011)
    56. [56]
      Underuse of ACE inhibitors and angiotensin II receptor blockers among patients with diabetic nephropathy in Taiwan.Yeh HL, Huang LY, Su S, Yang MC, Wang TC Health policy (Amsterdam, Netherlands) (2011)
    57. [57]
      Mechanisms of diabetic nephropathy--old buddies and newcomers part 1.Nawroth PP, Isermann B Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association (2010)
    58. [58]
      Mechanisms of diabetic nephropathy--old buddies and newcomers part 2.Nawroth PP, Isermann B Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association (2010)
    59. [59]
      Major role for ACE-independent intrarenal ANG II formation in type II diabetes.Park S, Bivona BJ, Kobori H, Seth DM, Chappell MC, Lazartigues E et al. American journal of physiology. Renal physiology (2010)
    60. [60]
      XLF-III-43, a novel coumarin-aspirin compound, prevents diabetic nephropathy in rats via inhibiting advanced glycation end products.Li H, Zheng X, Wang H, Zhang Y, Xin H, Chen X European journal of pharmacology (2010)
    61. [61]
      Abdominal decompression for intra-abdominal hypertension after simultaneous pancreas-kidney transplantation.Decoster T, Vermassen FE, Peeters PC, Hoste EA, De Waele JJ Clinical transplantation (2010)
    62. [62]
      Risk factors for early onset of diabetic nephropathy in pediatric type 1 diabetes.Salgado PP, Silva IN, Vieira EC, Simões e Silva AC Journal of pediatric endocrinology & metabolism : JPEM (2010)
    63. [63]
    64. [64]
      Avosentan for overt diabetic nephropathy.Mann JF, Green D, Jamerson K, Ruilope LM, Kuranoff SJ, Littke T et al. Journal of the American Society of Nephrology : JASN (2010)
    65. [65]
    66. [66]
      Longitudinal ultrasound evaluation of carotid atherosclerosis in one, two and three dimensions.Mallett C, House AA, Spence JD, Fenster A, Parraga G Ultrasound in medicine & biology (2009)
    67. [67]
      Evaluation of genetic association and expression reduction of TRPC1 in the development of diabetic nephropathy.Zhang D, Freedman BI, Flekac M, Santos E, Hicks PJ, Bowden DW et al. American journal of nephrology (2009)
    68. [68]
      Addition of angiotensin receptor blockade or mineralocorticoid antagonism to maximal angiotensin-converting enzyme inhibition in diabetic nephropathy.Mehdi UF, Adams-Huet B, Raskin P, Vega GL, Toto RD Journal of the American Society of Nephrology : JASN (2009)
    69. [69]
      Optimal dose of lisinopril for renoprotection in type 1 diabetic patients with diabetic nephropathy: a randomised crossover trial.Schjoedt KJ, Astrup AS, Persson F, Frandsen E, Boomsma F, Rossing K et al. Diabetologia (2009)
    70. [70]
      Measurement of the intrarenal arterial resistance index for the identification and prediction of diabetic nephropathy.Masulli M, Mancini M, Liuzzi R, Daniele S, Mainenti PP, Vergara E et al. Nutrition, metabolism, and cardiovascular diseases : NMCD (2009)
    71. [71]
      Clinical indicators which necessitate renal biopsy in type 2 diabetes mellitus patients with renal disease.Lin YL, Peng SJ, Ferng SH, Tzen CY, Yang CS International journal of clinical practice (2009)
    72. [72]
      Olmesartan reduced microalbuminuria in Japanese subjects with type 2 diabetes.Ikeda H, Hamamoto Y, Honjo S, Nabe K, Wada Y, Koshiyama H Diabetes research and clinical practice (2009)
    73. [73]
      Drug information needs of physicians treating diabetic nephropathy in a tertiary care hospital.Devi P, George J Kathmandu University medical journal (KUMJ) (2008)
    74. [74]
    75. [75]
      The association of plasma fibrinogen concentration with diabetic microvascular complications in young adults with early-onset of type 2 diabetes.Le DS, Miles R, Savage PJ, Cornell E, Tracy RP, Knowler WC et al. Diabetes research and clinical practice (2008)
    76. [76]
      Cobalt ameliorates renal injury in an obese, hypertensive type 2 diabetes rat model.Ohtomo S, Nangaku M, Izuhara Y, Takizawa S, Strihou Cv, Miyata T Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association (2008)
    77. [77]
    78. [78]
      An Asian regional analysis of cost-effectiveness of early irbesartan treatment versus conventional antihypertensive, late amlodipine, and late irbesartan treatments in patients with type 2 diabetes, hypertension, and nephropathy.Annemans L, Demarteau N, Hu S, Lee TJ, Morad Z, Supaporn T et al. Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research (2008)
    79. [79]
    80. [80]
    81. [81]
      Importance of glycemic control on the course of glomerular filtration rate in type 2 diabetes with hypertension and microalbuminuria under tight blood pressure control.Thomaseth K, Pacini G, Morelli P, Tonolo G, Nosadini R Nutrition, metabolism, and cardiovascular diseases : NMCD (2008)
    82. [82]
      Acute renal failure and myalgia in a transplant patient.Najafian B, Franklin DB, Fogo AB Journal of the American Society of Nephrology : JASN (2007)
    83. [83]
      Distinguishing diabetic nephropathy from other causes of glomerulosclerosis: an update.Alsaad KO, Herzenberg AM Journal of clinical pathology (2007)
    84. [84]
    85. [85]
      RAGE in diabetic nephropathy.Yamamoto H, Watanabe T, Yamamoto Y, Yonekura H, Munesue S, Harashima A et al. Current molecular medicine (2007)
    86. [86]
      Protocol of the Long-term Impact of RAS Inhibition on Cardiorenal Outcomes (LIRICO) randomized trial.Maione A, Nicolucci A, Craig JC, Tognoni G, Moschetta A, Palasciano G et al. Journal of nephrology (2007)
    87. [87]
      Thiazolidinediones provide better renoprotection than insulin in an obese, hypertensive type II diabetic rat model.Ohtomo S, Izuhara Y, Takizawa S, Yamada N, Kakuta T, van Ypersele de Strihou C et al. Kidney international (2007)
    88. [88]
      Renal injury in streptozotocin-diabetic Ren2-transgenic rats is mainly dependent on hypertension, not on diabetes.Hartner A, Cordasic N, Klanke B, Wittmann M, Veelken R, Hilgers KF American journal of physiology. Renal physiology (2007)
    89. [89]
      Altered renal sodium transporter expression in an animal model of type 2 diabetes mellitus.Oh YK, Joo KW, Lee JW, Jeon US, Lim CS, Han JS et al. Journal of Korean medical science (2007)
    90. [90]
      Dynamic blood pressure load and nephropathy in the ZSF1 (fa/fa cp) model of type 2 diabetes.Griffin KA, Abu-Naser M, Abu-Amarah I, Picken M, Williamson GA, Bidani AK American journal of physiology. Renal physiology (2007)
    91. [91]
      Anemia and diabetic nephropathy.Ritz E Current diabetes reports (2006)
    92. [92]
      Management of cardiovascular risk factors in advanced type 2 diabetic nephropathy: a comparative analysis in nephrology, diabetology and primary care settings.Minutolo R, Sasso FC, Chiodini P, Cianciaruso B, Carbonara O, Zamboli P et al. Journal of hypertension (2006)
    93. [93]
      A French cost-consequence analysis of the renoprotective benefits of irbesartan in patients with type 2 diabetes and hypertension.Palmer AJ, Valentine WJ, Tucker DM, Ray JA, Roze S, Annemans L et al. Current medical research and opinion (2006)
    94. [94]
      Diabetic nephropathy.Ritz E Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia (2006)
    95. [95]
      Beneficial effect of lisinopril plus telmisartan in patients with type 2 diabetes, microalbuminuria and hypertension.Sengul AM, Altuntas Y, Kürklü A, Aydin L Diabetes research and clinical practice (2006)
    96. [96]
    97. [97]
    98. [98]
      Renal expression and localization of the facilitative glucose transporters GLUT1 and GLUT12 in animal models of hypertension and diabetic nephropathy.Linden KC, DeHaan CL, Zhang Y, Glowacka S, Cox AJ, Kelly DJ et al. American journal of physiology. Renal physiology (2006)
    99. [99]
      Diabetic nephropathy and anaemia.Ritz E, Haxsen V European journal of clinical investigation (2005)
    100. [100]
      Microalbuminuria prevalence study (MAPS) in hypertensive patients with type 2 diabetes in Thailand.Buranakitjaroen P, Deerochanawong C, Bunnag P Journal of the Medical Association of Thailand = Chotmaihet thangphaet (2005)

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