Diabetic nephropathy: Aggressive involvement of oxidative stress

Diabetic nephropathy is a major microvascular complication of diabetes mellitus and the most common cause of end-stage renal disease worldwide. Hyperglycemia, a well-recognized pathogenetic factor of long-term complications in diabetes mellitus, generates reactive oxygen species (ROS) mainly through NADPH oxidase, polyol pathway and advanced glycation products. Further, diabetes activates protein kinase C which promotes excessive formation of oxidative stress in the renal cellular milieu. Additionally, ROS mediate hyperglycemiainduced activation of signal transduction cascades and transcription factors leading to transcriptional activation of profibrotic genes in the kidney. However, maintaining intensive glycemic control and timely use of current therapies may help to reduce oxidative stress mediated progression of diabetic nephropathy.