Diabetic nephropathy: An outline on molecular mechanism and protective pathways of phytoconstituents

Abstract

Diabetic nephropathy is a debilitating complication of diabetes mellitus characterized by progressive kidney damage. This review provides a comprehensive overview of the molecular pathways underlying its pathogenesis and explores the protective mechanisms offered by various phytobioactives. The pathogenetic mechanisms of diabetic nephropathy are multifaceted, encompassing the activation of key pathways such as the rennin angiotensin-aldosterone system (RAAS), the polyol pathway, protein kinase C (PKC) pathway, hexosamine pathway, and the formation of advanced glycation end products (AGEs). Understanding these pathways is crucial for developing effective therapeutic strategies to combat diabetic nephropathy. In parallel, this review sheds light on the role of phytobioactives, including alkaloids, flavonoids, tannins, and stilbenes, in mitigating the progression of diabetic nephropathy. These natural compounds exhibit a spectrum of protective properties, including antioxidative and anti-inflammatory effects. Their ability to modulate the molecular pathways implicated in diabetic nephropathy offers promising avenues for novel therapeutic interventions. This review of the pathogenetic mechanisms and the protective potential of phytobioactives underscore the importance of considering natural compounds as adjunctive therapies in managing diabetic nephropathy, potentially improving patient outcomes and quality of life.