{"title":"The burden of diabetic nephropathy in India: Need for prevention","authors":"V. Viswanathan, Reshma Mirshad","doi":"10.2478/dine-2023-0003","DOIUrl":"https://doi.org/10.2478/dine-2023-0003","url":null,"abstract":"Abstract Diabetic nephropathy (DN) is a growing public health problem with a high economic burden. DN is the main cause of chronic kidney disease (CKD) and end-stage renal disease (ESRD). The pathogenesis and risk factors associated with DN must be assessed to better understand the disease and its complications. Therefore, the early identification and treatment of DN have been shown to slow, stop, or even reverse the progression of ESRD.","PeriodicalId":89356,"journal":{"name":"Diabetic nephropathy : DN","volume":"101 1","pages":"25 - 28"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88336850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yaling Zhang, Song Ren, Yuan Zhang, Li Wang, Guisen Li
{"title":"Efficacy and safety of dual blockade of the renin-angiotensin-aldosterone system in diabetic kidney disease: A meta-analysis","authors":"Yaling Zhang, Song Ren, Yuan Zhang, Li Wang, Guisen Li","doi":"10.2478/dine-2023-0002","DOIUrl":"https://doi.org/10.2478/dine-2023-0002","url":null,"abstract":"Abstract Objective To compare the relative efficacy and safety of dual blockade with sole blockade of the renin-angiotensin-aldosterone system in diabetic kidney disease. Method Studies were selected by searching the databases of MEDLINE, EMBASE, PubMed, and China National Knowledge Infrastructure (CNKI). All trials with angiotensin-converting enzyme inhibitor (ACEI) + angiotensin II type 1 (AT1) receptor blocker (ARB) (combination therapy), ACEI alone, or ARB alone (monotherapy) for treatment of diabetic kidney disease were included. The clinical parameters included for comparison were the progression to end-stage kidney disease (ESKD) or the outcomes of death, serum creatinine, glomerular filtration rate (GFR), serum potassium, 24-h urinary protein, urine albumin-to-creatinine ratio (UACR), urinary albumin excretion rate (UAER), and blood pressure. Results Twenty-two studies involving 6492 participants were eventually included. Compared to ACEI or ARB alone, a combination of ACEI and ARB can greatly reduce urine protein by 160 mg/d, the level of ACR significantly, as well as the systolic and diastolic blood pressures. The increase of serum creatinine and the decrease of GFR were more obvious in the combination treatment group. There was no significant difference in endpoint events between the two groups. The serum potassium level was significantly increased in the combination treatment group. Conclusions ACEI combined with ARB in the treatment of diabetic kidney disease can significantly reduce the level of proteinuria, decrease the blood pressure, and delay the progression of kidney disease. Moreover, it has some risk of increasing serum potassium and serum creatinine compared with monotherapy; so, careful attention is needed in dual blockade treatment.","PeriodicalId":89356,"journal":{"name":"Diabetic nephropathy : DN","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136350623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ming Yang, Yan Liu, Shilu Luo, Ying Xiao, Chanyue Zhao, Lin Sun
{"title":"Renal lipid deposition and diabetic nephropathy","authors":"Ming Yang, Yan Liu, Shilu Luo, Ying Xiao, Chanyue Zhao, Lin Sun","doi":"10.2478/dine-2023-0001","DOIUrl":"https://doi.org/10.2478/dine-2023-0001","url":null,"abstract":"Abstract Diabetic nephropathy (DN) is a serious complication of diabetes mellitus and the main cause of end-stage renal disease (ESRD). Lipid metabolism disorders are a common clinical manifestation of DN and are involved in the development of DN. Ectopic lipid deposition refers to lipids deposited in nonadipose tissue, such as liver, brain, skeletal muscle, and kidney. Recently, renal lipid deposition has been shown to play an important role in the pathological progression of DN. In this review, we summarize our understanding of the molecular mechanisms of renal lipid deposition and explore the relationship between renal lipid deposition and renal injury in DN.","PeriodicalId":89356,"journal":{"name":"Diabetic nephropathy : DN","volume":"98 1","pages":"17 - 24"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72969197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Treatment with rituximab and hydroxychloroquine in a patient with membranous nephropathy and diabetic nephropathy: A case report","authors":"Xiaoyuan Ning, Na Xu, Mengke Chen, Jiayun Xu","doi":"10.2478/dine-2022-0020","DOIUrl":"https://doi.org/10.2478/dine-2022-0020","url":null,"abstract":"Abstract Nephrotic syndrome (NS), which includes primary and secondary types, is one of the causes of end-stage kidney disease. Common causes in adults include diabetic nephropathy (DN), membranous nephropathy (MN), and focal segmental glomerulosclerosis. About 30%–40% of diabetics can develop into DN. The incidence of primary nephrotic syndrome in diabetic patients was not significantly different from that in the general population. Herein we present a windfall from the treatment of rituximab combined with hydroxychloroquine in a patient with primary MN and DN. A 51-year-old Chinese man, diagnosed with type 2 diabetes mellitus (T2DM) 12 years ago, was admitted to the hospital due to edema of bilateral lower limbs and severe proteinuria. Serology showed the obvious elevation of the anti-phospholipase A2 receptor (anti-PLA2R) level and renal biopsy showed MN concomitant with DN. After low dosage of prednisone and standard dosage of rituximab, the patient’s proteinuria decreased; however, the effect was unsatisfactory and proteinuria was elevated again in 8 months. Thus, treatment with rituximab and hydroxychloroquine was initiated, which resulted in proteinuria diminishing significantly and albumin returning to normal level. Therefore, even complicated with DN, patients diagnosed with primary MN still have a promising remission after being treated with rituximab and hydroxychloroquine.","PeriodicalId":89356,"journal":{"name":"Diabetic nephropathy : DN","volume":"11 1","pages":"10 - 14"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78408049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Basina, T. McLaughlin, J. Tokita, A. Vega, A. Zabetian, Allison Trucillo, G. Nadkarni, Michael J Donovan, J. Vassalotti, S. Coca, David W Lam
{"title":"The need for risk stratification in type 2 diabetes and chronic kidney disease: Proposed clinical value of KidneyIntelX","authors":"M. Basina, T. McLaughlin, J. Tokita, A. Vega, A. Zabetian, Allison Trucillo, G. Nadkarni, Michael J Donovan, J. Vassalotti, S. Coca, David W Lam","doi":"10.2478/dine-2022-0019","DOIUrl":"https://doi.org/10.2478/dine-2022-0019","url":null,"abstract":"Abstract Chronic kidney disease (CKD) develops in > 40% of people living with diabetes and affects > 7 million people in the United States. Of the 15 million individuals with type 2 diabetes and CKD in the United States, > 90% are in the “early stages of CKD” (stages G1–G3). Standard risk stratification tools for progression of kidney disease have limitations, and lack precision at an individual level. Individualized risk tools, such as KidneyIntelX™, that incorporate well-validated prognostic protein biomarkers integrated with key clinical variables and are integrated into the electronic health record (EHR) can help address these challenges. KidneyIntelX can identify patients earlier in their disease course when intervention would be most impactful. Herein, 4 case studies are presented to demonstrate how 3 different physicians utilized KidneyIntelX to make clinical decisions and optimize the management of patients with type 2 diabetes and CKD.","PeriodicalId":89356,"journal":{"name":"Diabetic nephropathy : DN","volume":"21 1","pages":"1 - 9"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89073963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The histologic disorders and underlying mechanisms of podocytes during diabetes","authors":"Shirui Qian, H. Su, Chun Zhang","doi":"10.2478/dine-2022-0021","DOIUrl":"https://doi.org/10.2478/dine-2022-0021","url":null,"abstract":"Abstract Diabetic kidney disease (DKD), one of the most common chronic microvascular complications in diabetes mellitus (DM), is the leading cause of chronic kidney disease (CKD) and end-stage renal disease (ESRD) worldwide. The proteinuria in DKD is tightly related to dysmorphology of podocytes including hypertrophy, foot process widening along with its effacement, and ultimately the loss of podocytes. The maintenance of a normal slit diaphragm, actin cytoskeleton, electric charge of the podocyte, and the interplay between podocyte and glomerular basement membrane (GBM) is essential for the podocyte process’s morphology. And the mitotic catastrophe (MC), epithelial-mesenchymal transition, detachment, and apoptosis of podocyte account for the decreased density of podocytes in DKD. From the angle of signaling pathway, several routes including the renin-angiotensin system, insulin signaling, cyclooxygenases (COX) and prostanoids, and notch signaling are proven to play critical roles in podocyte disorders. In this review, we highlight the main histologic abnormalities of podocytes in DKD and focus on their underlying mechanisms.","PeriodicalId":89356,"journal":{"name":"Diabetic nephropathy : DN","volume":"1 1","pages":"56 - 61"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89698086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Diabetic nephropathy with primary membranous nephropathy: A case report","authors":"Donghong Ma, Yulong Hou, Xinyan Jia, M. Guo","doi":"10.2478/dine-2022-0018","DOIUrl":"https://doi.org/10.2478/dine-2022-0018","url":null,"abstract":"Abstract Diabetic nephropathy (DN) is one of the most common microvascular diseases in diabetes. Primary membranous nephropathy (PMN) is one of the most common causes of nephrotic syndrome (NS) in adults. Incidence of DN and PMN are increasing. DN complicated with PMN is rarely reported. We report a case of DN with PMN. Early diagnosis is very important, and appropriate treatment can often achieve good results.","PeriodicalId":89356,"journal":{"name":"Diabetic nephropathy : DN","volume":"17 1","pages":"52 - 55"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74447142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zhenjie Liu, Dongwei Liu, Yuanyuan Yang, Zhangsuo Liu
{"title":"Noncoding RNAs in diabetic nephropathy","authors":"Zhenjie Liu, Dongwei Liu, Yuanyuan Yang, Zhangsuo Liu","doi":"10.2478/dine-2022-0016","DOIUrl":"https://doi.org/10.2478/dine-2022-0016","url":null,"abstract":"Abstract Diabetic nephropathy (DN) is a major microvascular complication in diabetic patients. It has become the leading cause of end-stage renal disease (ESRD) in individuals living in urban areas undergoing dialysis. DN diagnosis primarily depends on the course of diabetes and the detection of albuminuria. However, the onset of DN is obscure, and many patients have already developed ESRD when they are diagnosed with DN. Hence, early diagnosis of DN progression and early interventional strategies are essential. Noncoding RNAs (ncRNAs) are a class of RNA transcripts that are transcribed from DNA but are not translated into proteins. They play an important role in regulating gene expression and protein synthesis. Several studies have demonstrated that ncRNAs are abundantly present in the blood, urine, and tissues and have the potential to aid in the diagnosis and treatment of DN. This review focuses on the role of microRNAs, long ncRNAs, and circular RNAs in DN and their potential value as biomarkers and therapeutic targets.","PeriodicalId":89356,"journal":{"name":"Diabetic nephropathy : DN","volume":"31 1","pages":"39 - 51"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90524323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}