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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Vydané v:Nature reviews. Nephrology Ročník 14; číslo 6; s. 361 - 377
Hlavní autori: Anders, Hans-Joachim, Huber, Tobias B, Isermann, Berend, Schiffer, Mario
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: England Nature Publishing Group 01.06.2018
Predmet:
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
ISSN:1759-5061, 1759-507X, 1759-507X
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Shrnutí: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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ISSN:1759-5061
1759-507X
1759-507X
DOI:10.1038/s41581-018-0001-y