Therapeutic Approaches in the Diagnosis and Treatment of Diabetic Nephropathy

Vedad Herenda ^1,2

1 Clinic for Nephrology, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
2 Sarajevo Medical School, University Sarajevo School of Science and Technology, Sarajevo, Bosnia and Herzegovina

Corresponding Author: Vedad Herenda MD, MSc. Clinic for Nephrology, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina; E-mail: vedad.herenda@gmail.com; Phone: +387 33 297-400; ORCID ID: 0000-0002-5640-1474.

Cite this article: Herenda V. Therapeutic Approaches in the Diagnosis and Treatment of Diabetic Nephropathy. Sar Med J 2025; 2(2):129-138. 10.70119/0041-25

Pages: 129 – 138 / Published online: 27 December 2025.

Original submission: 10 September 2025; Revised submission: 18 December 2025; Accepted: 26 December 2025.

Abstract

Diabetic nephropathy (DN) is the leading cause of end-stage kidney disease (ESKD). Despite advancements in conventional therapy, a significant number of patients continue to develop terminal kidney failure. In recent years, research has been focused on new diagnostic and therapeutic approaches including advanced biomarkers, pharmacogenetics and epigenetic indicators. Also, novel drugs have demonstrated significant nephroprotective and CV benefits in the treatment of DN. However, limited understanding of long-term renal outcomes remains. This narrative review aims to address this gap by critically assessing the long-term effects and effectiveness of these novel therapies, with a focus on patient subgroups and the personalized treatment implications. The potential of antifibrotic agents and personalized medicine approaches based on genetic and epigenetic profiles is explore, and the need for future research is emphasized, as it is crucial to improve DN treatment outcomes. The review underscores the necessity of multidisciplinary collaboration to develop effective, safe, and economically viable therapeutic strategies for managing DN.

Keywords: Diabetic Nephropathy, Chronic Kidney Disease, Albuminuria, Renal Fibrosis, Renoprotection.