The real culprit behind diabetic nephropathy: impaired renal autoregulation?

More than 29 million of Americans have diabetes. About 30–40% of the diabetic patients will eventually develop diabetic nephropathy (DN), which is the leading cause of end‐stage renal disease (Centers for Disease Control and Prevention, 2014; United States Renal Data System., 2012). Control of blood pressure (BP) and blood glucose has been shown to reduce the risk of developing DN (Nathan 2014). However, not all patients with poor control in BP and plasma glucose will develop renal disease. On the other hand, over 1/3 of patients with type 2 diabetes develop DN despite strict control of BP and/or blood glucose (Mooyaart 2014; Tomino and Gohda 2015). Therefore, further understanding the pathophysiological mechanisms underlying the DN is essential to identify potential target for treatment