Diabetic nephropathy. A modern view of the problem

Diabetes mellitus (DM) is a disease that accompanies a person for a long period of time. The greatest danger of diabetes is undoubtedly associated with complications that develop due to its damaging effects on blood vessels, particularly diabetic nephropathy (DN), which develops in approximately 20.1% of patients with diabetes of the 1st type and 6.3% of patients with diabetes of the 2nd type. In patients with diabetes of the 2nd type, diabetic nephropathy ranks third among causes of death after diseases of the cardiovascular system and oncological pathologies. There are many mechanisms of damaging effects of various factors that play a key role in the development of renal pathology in diabetes. We focused on a more detailed examination of the effect of renin-angiotensin-aldosterone (RAAS), direct damaging effects of hyperglycemia, polyol glucose metabolism, and hyperlipidemia, endothelial growth factor (VEGF) and transforming growth factor β (TGF-β). Based on the knowledge of the pathogenesis of diabetic nephropathy, very promising targets have been identified for the correction of this pathology.