CKD in diabetes: diabetic kidney disease versus nondiabetic kidney disease
The increasing global prevalence of type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD) has prompted research efforts to tackle the growing epidemic of diabetic kidney disease (DKD; also known as diabetic nephropathy). The limited success of much of this research might in part be due to...
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| Published in: | Nature reviews. Nephrology Vol. 14; no. 6; pp. 361 - 377 |
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| Main Authors: | , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
England
Nature Publishing Group
01.06.2018
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| Subjects: | |
| ISSN: | 1759-5061, 1759-507X, 1759-507X |
| Online Access: | Get full text |
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| Abstract | The increasing global prevalence of type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD) has prompted research efforts to tackle the growing epidemic of diabetic kidney disease (DKD; also known as diabetic nephropathy). The limited success of much of this research might in part be due to the fact that not all patients diagnosed with DKD have renal dysfunction as a consequence of their diabetes mellitus. Patients who present with CKD and diabetes mellitus (type 1 or type 2) can have true DKD (wherein CKD is a direct consequence of their diabetes status), nondiabetic kidney disease (NDKD) coincident with diabetes mellitus, or a combination of both DKD and NDKD. Preclinical studies using models that more accurately mimic these three entities might improve the ability of animal models to predict clinical trial outcomes. Moreover, improved insights into the pathomechanisms that are shared by these entities - including sodium-glucose cotransporter 2 (SGLT2) and renin-angiotensin system-driven glomerular hyperfiltration and tubular hyper-reabsorption - as well as those that are unique to individual entities might lead to the identification of new treatment targets. Acknowledging that the clinical entity of CKD plus diabetes mellitus encompasses NDKD as well as DKD could help solve some of the urgent unmet medical needs of patients affected by these conditions. |
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| AbstractList | The increasing global prevalence of type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD) has prompted research efforts to tackle the growing epidemic of diabetic kidney disease (DKD; also known as diabetic nephropathy). The limited success of much of this research might in part be due to the fact that not all patients diagnosed with DKD have renal dysfunction as a consequence of their diabetes mellitus. Patients who present with CKD and diabetes mellitus (type 1 or type 2) can have true DKD (wherein CKD is a direct consequence of their diabetes status), nondiabetic kidney disease (NDKD) coincident with diabetes mellitus, or a combination of both DKD and NDKD. Preclinical studies using models that more accurately mimic these three entities might improve the ability of animal models to predict clinical trial outcomes. Moreover, improved insights into the pathomechanisms that are shared by these entities — including sodium–glucose cotransporter 2 (SGLT2) and renin–angiotensin system-driven glomerular hyperfiltration and tubular hyper-reabsorption — as well as those that are unique to individual entities might lead to the identification of new treatment targets. Acknowledging that the clinical entity of CKD plus diabetes mellitus encompasses NDKD as well as DKD could help solve some of the urgent unmet medical needs of patients affected by these conditions. The increasing global prevalence of type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD) has prompted research efforts to tackle the growing epidemic of diabetic kidney disease (DKD; also known as diabetic nephropathy). The limited success of much of this research might in part be due to the fact that not all patients diagnosed with DKD have renal dysfunction as a consequence of their diabetes mellitus. Patients who present with CKD and diabetes mellitus (type 1 or type 2) can have true DKD (wherein CKD is a direct consequence of their diabetes status), nondiabetic kidney disease (NDKD) coincident with diabetes mellitus, or a combination of both DKD and NDKD. Preclinical studies using models that more accurately mimic these three entities might improve the ability of animal models to predict clinical trial outcomes. Moreover, improved insights into the pathomechanisms that are shared by these entities - including sodium-glucose cotransporter 2 (SGLT2) and renin-angiotensin system-driven glomerular hyperfiltration and tubular hyper-reabsorption - as well as those that are unique to individual entities might lead to the identification of new treatment targets. Acknowledging that the clinical entity of CKD plus diabetes mellitus encompasses NDKD as well as DKD could help solve some of the urgent unmet medical needs of patients affected by these conditions.The increasing global prevalence of type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD) has prompted research efforts to tackle the growing epidemic of diabetic kidney disease (DKD; also known as diabetic nephropathy). The limited success of much of this research might in part be due to the fact that not all patients diagnosed with DKD have renal dysfunction as a consequence of their diabetes mellitus. Patients who present with CKD and diabetes mellitus (type 1 or type 2) can have true DKD (wherein CKD is a direct consequence of their diabetes status), nondiabetic kidney disease (NDKD) coincident with diabetes mellitus, or a combination of both DKD and NDKD. Preclinical studies using models that more accurately mimic these three entities might improve the ability of animal models to predict clinical trial outcomes. Moreover, improved insights into the pathomechanisms that are shared by these entities - including sodium-glucose cotransporter 2 (SGLT2) and renin-angiotensin system-driven glomerular hyperfiltration and tubular hyper-reabsorption - as well as those that are unique to individual entities might lead to the identification of new treatment targets. Acknowledging that the clinical entity of CKD plus diabetes mellitus encompasses NDKD as well as DKD could help solve some of the urgent unmet medical needs of patients affected by these conditions. |
| Author | Isermann, Berend Huber, Tobias B Schiffer, Mario Anders, Hans-Joachim |
| Author_xml | – sequence: 1 givenname: Hans-Joachim orcidid: 0000-0003-2434-2956 surname: Anders fullname: Anders, Hans-Joachim email: hjanders@med.uni-muenchen.de organization: Division of Nephrology, Medizinische Klinik and Poliklinik IV, Klinikum der LMU München - Innenstadt, München, Germany. hjanders@med.uni-muenchen.de – sequence: 2 givenname: Tobias B surname: Huber fullname: Huber, Tobias B organization: III. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany – sequence: 3 givenname: Berend surname: Isermann fullname: Isermann, Berend organization: Institute of Clinical Chemistry and Pathobiochemistry, Otto von Guericke University Magdeburg, Magdeburg, Germany – sequence: 4 givenname: Mario surname: Schiffer fullname: Schiffer, Mario organization: Department of Nephrology, Hannover Medical School, Hannover, Germany |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/29654297$$D View this record in MEDLINE/PubMed |
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| Snippet | The increasing global prevalence of type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD) has prompted research efforts to tackle the growing... |
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| SubjectTerms | Animals Biopsy Cardiovascular Diseases - diagnosis Cardiovascular Diseases - physiopathology Cardiovascular Diseases - prevention & control Clinical trials Diabetes Diabetes Mellitus - physiopathology Diabetic Nephropathies - diagnosis Diabetic Nephropathies - physiopathology Diabetic Nephropathies - prevention & control Diabetic nephropathy Disease Models, Animal Disease Progression Glucose Kidney diseases Primary Prevention Renin-Angiotensin System Sodium-Glucose Transporter 2 |
| Title | CKD in diabetes: diabetic kidney disease versus nondiabetic kidney disease |
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