Diabetic nephropathy: strategies for preventing renal failure
JAMES K. SALEM, MD
Dr. Salem currently practices endocrinology in Akron, OH, after a fellowship in endocrinology at the Cleveland Clinic.
BYRON J. HOOGWERF, MD
Dr. Hoogwerf is a staff endocrinologist at the Cleveland Clinic, with a special interest in the management of diabetes and its complications. He is the chairman of the American Diabetes Association's Council on Nutrition and helped draft the consensus statement on diabetic nephropathy.
Better understanding of diabetic nephropathy's pathophysiology has led to fundamental changes in its management: detecting nephropathy early and intervening with rigorous glycemic control and aggressive management of hypertension may slow its progression. Dietary protein restriction may also have a role.