S.No

Conventional handicaps under current practice of DN

1

Insensitive diagnostic markers such as serum creatinine, microalbuminuria detects DN only at late stage CKD (CKD stage 3)

2

Definition of CKD inappropriately limits to CKD stage 3.

3

Therapeutic targets are multiple and indecisive to correct the chronic renal ischemia which is the crucial mechanism of renal disease progressive.

4

Treatment of DN at late stage CKD is resistant to vasodilators, which is due to altered vascular homeostasis associated with an impaired nitric oxide production.