Suggested mechanisms underlying the development and progression of diabetic nephropathy

Several mechanisms have been proposed to be responsible for the development of diabetic nephropathy. None of these are mutually exclusive, and it is likely that interactions among many of these factors contribute to diabetic nephropathy. An understanding of these mechanisms is essential for producing appropriate therapies to prevent both the development and progression of diabetic nephropathy. A number of existing therapies, as well as treatments currently in development or in clinical trials, are based on altering one or more of the mechanisms shown in this figure.