Nephrology Referral in Diabetes Practice

AbstractDiabetic nephropathy, including diabetic kidney disease (DKD), is a major complication of diabetes. Appropriate management of DKD requires multispecialty intervention under the guidance of endocrinology and nephrology. However, delayed referral to specialized nephrology services usually occurs, and this leads to suboptimal outcomes. This multispecialty consensus suggests simple clinical and biochemical parameters that should prompt referral of DKD patients to nephrology. A checklist for physicians who manage DKD is also provided.

Download Full-text

miR-379 deletion ameliorates features of diabetic kidney disease by enhancing adaptive mitophagy via FIS1

Communications Biology ◽

10.1038/s42003-020-01516-w ◽

2021 ◽

Vol 4 (1) ◽

Author(s):

Mitsuo Kato ◽

Maryam Abdollahi ◽

Ragadeepthi Tunduguru ◽

Walter Tsark ◽

Zhuo Chen ◽

...

Keyword(s):

Kidney Disease ◽

Diabetic Kidney Disease ◽

Mesangial Cells ◽

Mitochondrial Fission ◽

Major Complication ◽

Body Weight Loss ◽

Diabetic Kidney ◽

Guide Rna ◽

And Oxidative Stress

AbstractDiabetic kidney disease (DKD) is a major complication of diabetes. Expression of members of the microRNA (miRNA) miR-379 cluster is increased in DKD. miR-379, the most upstream 5′-miRNA in the cluster, functions in endoplasmic reticulum (ER) stress by targeting EDEM3. However, the in vivo functions of miR-379 remain unclear. We created miR-379 knockout (KO) mice using CRISPR-Cas9 nickase and dual guide RNA technique and characterized their phenotype in diabetes. We screened for miR-379 targets in renal mesangial cells from WT vs. miR-379KO mice using AGO2-immunopreciptation and CLASH (cross-linking, ligation, sequencing hybrids) and identified the redox protein thioredoxin and mitochondrial fission-1 protein. miR-379KO mice were protected from features of DKD as well as body weight loss associated with mitochondrial dysfunction, ER- and oxidative stress. These results reveal a role for miR-379 in DKD and metabolic processes via reducing adaptive mitophagy. Strategies targeting miR-379 could offer therapeutic options for DKD.

Download Full-text

Diabetic kidney disease in thedb/dbmouse

AJP Renal Physiology ◽

10.1152/ajprenal.00315.2002 ◽

2003 ◽

Vol 284 (6) ◽

pp. F1138-F1144 ◽

Cited By ~ 267

Author(s):

Kumar Sharma ◽

Peter McCue ◽

Stephen R. Dunn

Keyword(s):

Diabetic Nephropathy ◽

Kidney Disease ◽

Mouse Model ◽

Renal Disease ◽

Mouse Models ◽

Diabetic Kidney Disease ◽

Diabetic Kidney ◽

Matrix Expansion ◽

Stage Renal Disease ◽

End Stage

Diabetic nephropathy is increasing in incidence and is now the number one cause of end-stage renal disease in the industrialized world. To gain insight into the genetic susceptibility and pathophysiology of diabetic nephropathy, an appropriate mouse model of diabetic nephropathy would be critical. A large number of mouse models of diabetes have been identified and their kidney disease characterized to various degrees. Perhaps the best characterized and most intensively investigated model is the db/ db mouse. Because this model appears to exhibit the most consistent and robust increase in albuminuria and mesangial matrix expansion, it has been used as a model of progressive diabetic renal disease. In this review, we present the findings from various studies on the renal pathology of the db/ db mouse model of diabetes in the context of human diabetic nephropathy. Furthermore, we discuss shortfalls of assessing functional renal disease in mouse models of diabetic kidney disease.

Download Full-text

Diabetic Retinopathy and Clinical Parameters Favoring the Presence of Diabetic Nephropathy could Predict Renal Outcome in Patients with Diabetic Kidney Disease

Scientific Reports ◽

10.1038/s41598-017-01204-6 ◽

2017 ◽

Vol 7 (1) ◽

Cited By ~ 11

Author(s):

Chi-Chih Hung ◽

Hugo You-Hsien Lin ◽

Daw-Yang Hwang ◽

I-Ching Kuo ◽

Yi-Wen Chiu ◽

...

Keyword(s):

Diabetic Retinopathy ◽

Diabetic Nephropathy ◽

Kidney Disease ◽

Diabetic Kidney Disease ◽

Renal Outcome ◽

Clinical Parameters ◽

Diabetic Kidney

Download Full-text

Urinary Markers of Glomerular Injury in Diabetic Nephropathy

International Journal of Nephrology ◽

10.1155/2012/146987 ◽

2012 ◽

Vol 2012 ◽

pp. 1-11 ◽

Cited By ~ 32

Author(s):

Abraham Cohen-Bucay ◽

Gautham Viswanathan

Keyword(s):

Renal Failure ◽

Diabetic Nephropathy ◽

Kidney Disease ◽

Current Literature ◽

Cardiovascular Events ◽

Diabetic Kidney Disease ◽

Glomerular Injury ◽

Diabetic Kidney ◽

Urinary Markers

Diabetic nephropathy, the leading cause of renal failure worldwide, affects approximately one-third of all people with diabetes. Microalbuminuria is considered the first sign and the best predictor of progression to renal failure and cardiovascular events. However, albuminuria has several limitations. Therefore, earlier, more sensitive and specific biomarkers with greater predictability are needed. The aim of this paper is to discuss the current literature on biomarkers of glomerular injury that have been implicated in diabetic kidney disease.

Download Full-text

The Japanese Registries of Diabetic Nephropathy/Diabetic Kidney Disease

Diabetic Kidney Disease ◽

10.1007/978-981-15-9301-7_2 ◽

2020 ◽

pp. 15-29

Author(s):

Miho Shimizu ◽

Takashi Wada

Keyword(s):

Diabetic Nephropathy ◽

Kidney Disease ◽

Diabetic Kidney Disease ◽

Diabetic Kidney

Download Full-text

Hydrogen Sulfide: Recent Progression and Perspectives for the Treatment of Diabetic Nephropathy

Molecules ◽

10.3390/molecules24152857 ◽

2019 ◽

Vol 24 (15) ◽

pp. 2857 ◽

Cited By ~ 12

Author(s):

Sun ◽

Wu ◽

Cao ◽

Zhu ◽

Liu ◽

...

Keyword(s):

Diabetic Nephropathy ◽

Hydrogen Sulfide ◽

Kidney Disease ◽

Renal Disease ◽

Diabetic Kidney Disease ◽

Renal Physiology ◽

Treatment Modalities ◽

Diabetic Patients ◽

Diabetic Kidney ◽

Diabetic Renal Disease

Diabetic kidney disease develops in approximately 40% of diabetic patients and is a major cause of chronic kidney diseases (CKD) and end stage kidney disease (ESKD) worldwide. Hydrogen sulfide (H2S), the third gasotransmitter after nitric oxide (NO) and carbon monoxide (CO), is synthesized in nearly all organs, including the kidney. Though studies on H2S regulation of renal physiology and pathophysiology are still in its infancy, emerging evidence shows that H2S production by renal cells is reduced under disease states and H2S donors ameliorate kidney injury. Specifically, aberrant H2S level is implicated in various renal pathological conditions including diabetic nephropathy. This review presents the roles of H2S in diabetic renal disease and the underlying mechanisms for the protective effects of H2S against diabetic renal damage. H2S may serve as fundamental strategies to treat diabetic kidney disease. These H2S treatment modalities include precursors for H2S synthesis, H2S donors, and natural plant-derived compounds. Despite accumulating evidence from experimental studies suggests the potential role of the H2S signaling pathway in the treatment of diabetic nephropathy, these results need further clinical translation. Expanding understanding of H2S in the kidney may be vital to translate H2S to be a novel therapy for diabetic renal disease.

Download Full-text

Circulating Expression Level of LncRNA Malat1 in Diabetic Kidney Disease Patients and Its Clinical Significance

Journal of Diabetes Research ◽

10.1155/2020/4729019 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Lian-ji Zhou ◽

Da-wei Yang ◽

Li-Na Ou ◽

Xing-Rong Guo ◽

Biao-liang Wu

Keyword(s):

Diabetes Mellitus ◽

Diabetic Nephropathy ◽

Kidney Disease ◽

Clinical Significance ◽

Diabetic Kidney Disease ◽

Glycosylated Hemoglobin ◽

Expression Level ◽

Diabetic Kidney ◽

Lncrna Malat1 ◽

Prediction Probability

Background. Long noncoding RNA MALAT1 is closely related to diabetes and kidney diseases and is expected to be a new target for the diagnosis and treatment of diabetic nephropathy. Objective. This study aimed to explore the circulating expression level and significance of lncRNA Malat1 in patients with type 2 diabetes mellitus (T2DM) and diabetic kidney disease (DKD). Methods. Quantitative real-time PCR (qPCR) was conducted to assess the expression of lncRNA Malat1 in 20 T2DM patients, 27 DKD patients, and 14 healthy controls, and then, the clinical significance was analyzed. Results. LncRNA MALAT1 expression in peripheral blood mononuclear cells (PBMC) was significantly upregulated in T2DM and DKD groups when compared to control. Pearson’s correlation analysis showed correlation of lncRNA MALAT1 levels with ACR, urine β2-microglobulin (β2-MG), urine α1-microglobulin (α1-MG), creatinine (Cr), and glycosylated hemoglobin (HbA1c), while negative with superoxide dismutase (SOD) (r=−0.388, P<0.05). Binary regression analysis showed that ACR, creatinine, α1-MG, and LncRNA Malat1 were the risk factors for diabetic nephropathy with OR value of 1.166, 1.031, 1.031, and 2.019 (P<0.05). The area under ROC curve (AUC) of DKD identified by the above indicators was 0.914, 0.643, 0.807, and 0.797, respectively. The AUC of Joint prediction probability of DKD recognition was 0.914, and the sensitivity and specificity of DKD diagnosis were 1.0 and 0.806, respectively. (Take ≥0.251 as the diagnostic cutoff point). Conclusion. LncRNA Malat1 is highly expressed in DKD patients, and the combined detection of ACR, creatinine, α1-MG, and LncRNA Malat1 with diabetes mellitus may be the best way to diagnose diabetic nephropathy.

Download Full-text

Antioxidant, Anti-Inflammatory, and Metabolic Properties of Tocopherols and Tocotrienols: Clinical Implications for Vitamin E Supplementation in Diabetic Kidney Disease

International Journal of Molecular Sciences ◽

10.3390/ijms20205101 ◽

2019 ◽

Vol 20 (20) ◽

pp. 5101 ◽

Cited By ~ 1

Author(s):

Angelo Di Vincenzo ◽

Claudio Tana ◽

Hamza El Hadi ◽

Claudio Pagano ◽

Roberto Vettor ◽

...

Keyword(s):

Diabetic Nephropathy ◽

Vitamin E ◽

Kidney Disease ◽

Diabetic Kidney Disease ◽

Vascular Complications ◽

High Morbidity ◽

Diabetic Kidney ◽

Anti Inflammatory ◽

Vitamin E Supplementation

Diabetes mellitus is a metabolic disorder characterized by the development of vascular complications associated with high morbidity and mortality and the consequent relevant costs for the public health systems. Diabetic kidney disease is one of these complications that represent the main cause of end-stage renal disease in Western countries. Hyperglycemia, inflammation, and oxidative stress contribute to its physiopathology, and several investigations have been performed to evaluate the role of antioxidant supplementation as a complementary approach for the prevention and control of diabetes and associated disturbances. Vitamin E compounds, including different types of tocopherols and tocotrienols, have been considered as a treatment to tackle major cardiovascular outcomes in diabetic subjects, but often with conflicting or even negative results. However, their effects on diabetic nephropathy are even less clear, despite several intervention studies that showed the improvement of renal parameters after supplementation in patients with diabetic kidney disease. Then we performed a review of the literature about the role of vitamin E supplementation on diabetic nephropathy, also describing the underlying antioxidant, anti-inflammatory, and metabolic mechanisms to evaluate the possible use of tocopherols and tocotrienols in clinical practice.

Download Full-text