Molecular Mechanism of Pathogenesis and Management of Diabetic Nephropathy

Kidney disease is continuously rising in the society, which may be acute or chronic. The earlier one is attributed to chemical pollution, side effects of drugs/food. The later is mainly due to life style related metabolic disorders, resulting to systemic low grade inflammation, oxidative stress, immunological hyperactivity and cellular apoptosis in kidney. Diabetes and high blood pressure are the main factors to induce chronic kidney disease (CKD). At molecular level it simultaneously activates several pathways, which collectively induce cell apoptosis/necrosis in various types of kidney cells, such as activation of protein kinase C (PKC) and transcription factors like NFkB and HIF-alpha. Their respective target genes have been identified as objective parameters to assess the severity of the disease and also to develop newer molecular therapeutics. This review emphasizes the prominent pathways and their signal transduction, which would be helpful in understanding the target molecules for development of newer drugs, to manage kidney diseases. It also covers the possible therapeutic modalities which are under development.