Diabetic kidney disease is the leading cause of end-stage renal disease. Albuminuria is recognized as the most important\nprognostic factor for chronic kidney disease progression. For this reason, blockade of renin-angiotensin system remains the main\nrecommended strategy, with either angiotensin converting enzyme inhibitors or angiotensin II receptor blockers. However, other\nantiproteinuric treatments have begun to be studied, such as direct renin inhibitors or aldosterone blockers. Beyond antiproteinuric\ntreatments, other drugs such as pentoxifylline or bardoxolone have yielded conflicting results. Finally, alternative pathogenic\npathways are being explored, and emerging therapies including antifibrotic agents, endothelin receptor antagonists, or transcription\nfactors show promising results. The aim of this review is to explain the advances in newer agents to treat diabetic kidney disease,\nalong with the background of the renin-angiotensin system blockade.
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