Polygenic Susceptibility and Environmental Determinants in the Progression of Diabetic Kidney Disease: A Multifactorial Risk Analysis

Abstract

Diabetic nephropathy is one of the most serious microvascular complications of diabetes mellitus, leading to the development of end-stage renal disease. The aim of this study was to comprehensively analyze the contribution of genetic predisposition and environmental factors to the risk of developing this pathology. A sample of patients with diabetes mellitus, with and without signs of kidney damage, was examined. Methods included genotyping of genetic polymorphisms of the renin-angiotensin system and endothelial nitric oxide synthase, assessment of glycemic control and blood pressure, as well as analysis of dietary habits and lifestyle. The study revealed that the presence of certain allelic variants of genes significantly increases the susceptibility of kidney tissue to the damaging effects of hyperglycemia. In addition, adverse environmental factors, such as smoking, uncontrolled hypertension, and long-term diabetic decompensation, considerably increase the genetic risk. The study concludes that diabetic nephropathy has a multifactorial nature. Considering a combination of genetic markers and modifiable factors allows for risk stratification and early application of individualized nephroprotective therapy.