Abstract
The pathogenesis of diabetic nephropathy is a multifactorial process where renin-angiotensin system activation plays a crucial role. The level of microalbuminuria or proteinuria is closely associated not only with the progression of diabetic nephropathy but also with cardiovascular events.
It is evident that reducing microalbuminuria results not only in slower decrease in the glomerular filtration rate but also in a better cardiovascular prognosis in patients with diabetic nephropathy and arterial hypertension. The prospects of diabetic patients with microalbuminuria has improved considerably over the last two decades, also thanks to early aggressive blood pressure lowering, renin-angiotensin system blockade and tight blood glucose control.
Nevertheless, further efforts are needed to improve the strategy of the prevention for diabetic nephropathy and its progression to chronic renal failure.