Despite the availability of current therapies that target hyperglycemia, hypertension, dyslipidemia and blockade of the renin-angiotensin-aldosterone (RAA) system, many people with diabetic chronic kidney disease (CKD) still progress to end stage renal disease (ESRD). Hence, new therapies to slow the progression of this important diabetic complication are urgently needed. Disappointingly many promising interventions for diabetic CKD have not coming to fruition when tested in large clinical trials. A recent clinical trial has shown that estimated GFR increases with bardoxolone. However, this finding awaits confirmation that it reflects changes in true GFR and translation into a reduction in clinical events. Here we discuss studies that have evaluated the effects of novel approaches to inhibiting the pathways involved in the pathogenesis of diabetic CKD
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