Evolving spectrum of diabetic nephropathy

Table 1 Pathophysiology of diabetic nephropathy and non-proteinuric diabetic nephropathy

Clinical parameter	Diabetic nephropathy	Non-proteinuric diabetic nephropathy
Proteinuria	Present	Absent
Regression of proteinuria	Present	Absent
Histology	Abnormal	Normal or abnormal
Glomerular filtration rate	Decreased	Decreased
Increased risk of chronic kidney disease	Present	Present

Table 2 Summary of non-proteinuric diabetic nephropathy literature

Field	Summary of non-proteinuric diabetic nephropathy literature
Prevalence	57% of diabetic nephropathy patients
Pathogenesis	Vascular and soluble elements, such as uric acid, TNFα, and VEGF, affecting renal microhemodynamics
Diagnosis	(1) Increased renal resistive index; (2) Alterations in TNFα, TGF-β, endothelin, and other interleukins
Treatment	(1) Enalapril; (2) Losartan; (3) Heparin; (4) Pentoxifylline

TNFα: Tumor necrosis factor alpha; VEGF: Vascular endothelial growth factor; TGF: Transforming growth factor.