Diabetic kidney disease is a complex pathologic process that involves many biochemical associations. As our understanding of this processes deepens, potential new targets for drug therapy become apparent. There are several mechanisms by which medications may be able to inhibit or slow the progression of kidney disease. Existing medications and entirely new compounds have been studied in human subjects that have antifibrotic and antioxidant effects as well as the ability to bind with and antagonize specific receptors known to contribute to the deleterious effects observed in diabetic kidney disease patients. While most potential new drug therapies remain highly experimental, there is a growing body of data from clinical trials show that many new drugs may eventually lead to new standards for drug treatment in diabetic kidney disease. Potential new drug therapies discussed include antifibrotic agents, antioxidant agents, ET-a receptor antagonists and other compounds with non-specific or multi-faceted mechanisms of action such as paricalcitol, ruboxistaurin, palosuran, allopurinol, and fasudil.
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