Which medication is commonly used to treat diabetic nephropathy?

• A. Thiazolidinedione
• B. Sulfonylurea
• C. ACE inhibitors
• D. Erythropoietin

Answer: (C)

In diabetic nephropathy, protecting the kidneys from ongoing injury and reducing protein leakage into the urine are key goals. Medications that block the renin-angiotensin system achieve this by lowering intraglomerular pressure, which reduces proteinuria and slows kidney damage. ACE inhibitors do this by inhibiting the formation of angiotensin II, leading to dilation of the efferent arteriole, lower glomerular pressure, and less proteinuric injury. They also aid in lowering blood pressure, which further protects the kidneys, and are commonly started in diabetics with albuminuria or hypertension to slow progression toward kidney failure.

Thiazolidinediones improve insulin sensitivity but don’t protect the kidneys from nephropathy and can cause fluid retention. Sulfonylureas help control blood glucose but don’t slow nephropathy progression. Erythropoietin treats anemia due to chronic kidney disease, not the underlying kidney injury itself.