Diabetic nephropathy is the most common cause of ESRD in the Western world and is responsible for almost a third of all the patients with ESRD in the United States. Approximately 20-30% of diabetic patients will develop kidney disease over their lifetime. However, possibly as a result of improvements in glycemic control and blood pressure therapy, the incidence of diabetic nephropathy seems to be declining (145-147). Therapies to prevent or delay the progression of diabetic nephropathy are thus critical and the various strategies effective at various stages are discussed below.
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