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Nephrol Dial Transplant (1999) 14: 2285-2288
© 1999 European Renal Association-European Dialysis and Transplant Association

Editorial Comments

Neuropathic pain in diabetic nephropathy—update on analgesic strategies

Dieter Luft

Medizinische Klinik und Poliklinik der Eberhard-Karls-Universität, Abteilung Innere Medizin IV, Tübingen, Germany

Correspondence and offprint requests to: Dieter Luft, MD, Medizinische Klinik und Poliklinik der Eberhard-Karls-Universität, Abteilung Innere Medizin IV, Otfried-Müller-Straße 10, D-72076 Tübingen, Germany.

Introduction

Diabetic neuropathies may impair quality of life, they are both prognostically and pathogenetically important factors for the development of the diabetic foot syndrome and associated with a reduced life expectancy. Improvement of metabolic control over the years has been proven to reduce the incidence of diabetic neuropathy in type 1 [1] and presumably also in type 2 diabetic patients [2,3]. In the near future, besides intensified diabetes treatment, metabolic steps important in the pathogenesis of diabetic neuropathy may be targeted by specific drugs effectively inhibiting the accumulation of sorbitol, reducing oxidative stress, stopping the formation of advanced glycation end products, improving nerve blood flow, reversing changes in membrane lipid metabolism, or substituting nerve growth factors. At present, and in the forseeable future, it seems to be impossible to completely eliminate the development of neuropathic diabetic lesions because normoglycaemia is achieved in only a small . . . [Full Text of this Article]

How to compare different drugs?

Physical measures

Normoglycaemic metabolic control

Tricyclic antidepressants

Selective serotonin reuptake inhibitors

Anticonvulsants

Antiarrhythmic drugs

Capsaicin

{alpha}-Lipoic acid

Opioids

Miscellanea

Treatment in nephropathic/neuropathic diabetic patients

Note added in proof

References


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