scholarly journals Diabetic kidney disease and pregnancy outcomes: a systematic review

2021 ◽  
Author(s):  
Sarah Gleeson ◽  
Shuli Svetitsky ◽  
Charlotte Frise
Keyword(s):  
Systematic Review ◽  
Kidney Disease ◽  
Renal Impairment ◽  
Pregnancy Outcomes ◽  
Neonatal Intensive Care ◽  
Diabetic Kidney Disease ◽  
Relevant Literature ◽  
Diabetic Kidney ◽  
Fetal Complications ◽  
Adverse Pregnancy

Introduction: We systematically reviewed all relevant literature on diabetic kidney disease (DKD) and pregnancy published in the last 20 years to provide accurate and up-to-date information to inform family planning and maternal care. Methods: A systematic review was completed in PubMed and Embase. Papers reporting maternal, fetal or renal outcomes of pregnant women with DKD published between 2001 and 2020 were included. Results: 799 potentially relevant articles were identified, 731 of which were excluded on abstract alone. 68 full-text articles were reviewed and 15 papers were included as they met the selection criteria but were heterogeneous for size, study setting and years studied. The definition of DKD varied between papers and changed over time. 843 women with 873 pregnancies were included. There were high rates of pre-eclampsia and caesarean section, up to 64% and 100% respectively. Prematurity and neonatal intensive care admission were common, reported in up to 100% and 75%, respectively. Maternal and fetal complications were more common with more severe proteinuria and renal impairment. Pregnancy did not hasten progression of DKD. Discussion: Adverse pregnancy outcomes are frequently encountered and correlate with degree of proteinuria and renal impairment. This information enables individualised risk stratification when a woman is considering pregnancy.

scholarly journals Antioxidant agents for delaying diabetic kidney disease progression: A systematic review and meta-analysis

PLoS ONE ◽  
2017 ◽  
Vol 12 (6) ◽  
pp. e0178699 ◽  
Author(s):  
Davide Bolignano ◽  
Valeria Cernaro ◽  
Guido Gembillo ◽  
Rossella Baggetta ◽  
Michele Buemi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Kidney Disease ◽  
Disease Progression ◽  
Diabetic Kidney Disease ◽  
Meta Analysis ◽  
Diabetic Kidney ◽  
Antioxidant Agents ◽  
Kidney Disease Progression

scholarly journals The Association between Obstructive Sleep Apnea on Diabetic Kidney Disease: A Systematic Review and Meta-Analysis

SLEEP ◽  
2016 ◽  
Vol 39 (2) ◽  
pp. 301-308 ◽  
Author(s):  
Wen Bun Leong ◽  
Ferozkhan Jadhakhan ◽  
Shahrad Taheri ◽  
G. Neil Thomas ◽  
Peymané Adab
Keyword(s):  
Systematic Review ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Kidney Disease ◽  
Diabetic Kidney Disease ◽  
Meta Analysis ◽  
Diabetic Kidney ◽  
Obstructive Sleep

scholarly journals Association of urinary activity of MMP-9 with renal impairment in Mexican patients with type 2 diabetes mellitus

PeerJ ◽  
2018 ◽  
Vol 6 ◽  
pp. e6067 ◽  
Author(s):  
Alan Uriel García-Tejeda ◽  
Clara Luz Sampieri ◽  
Irene Suárez-Torres ◽  
Jaime Morales-Romero ◽  
Verónica Patricia Demeneghi-Marini ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Kidney Disease ◽  
Renal Impairment ◽  
Diabetic Kidney Disease ◽  
Urinary Albumin ◽  
Diabetic Kidney ◽  
Mexican Patients

Background Diabetic kidney disease is the most common cause of chronic kidney disease (CKD). An early event in diabetic kidney disease is alteration of the glomerular basement membrane and the mesangial expansion. Matrix metalloproteinases (MMP) are a family of endopeptidases responsible for controlling the pathophysiological remodeling of tissues, including renal tissues. MMP-9 in human urine has been proposed as a marker of diabetic nephropathy and urinary tract infections (UTI). Methods A cross-sectional study was conducted in type 2 diabetes mellitus (T2DM) patients who receive first level medical attention in Mexico. We used ELISA to measure MMP-9 levels in the urine of subjects with T2DM ≥ 18 years of age, who fulfilled the clinical requirements for calculation of glomerular filtration rate (GFR), according to the K/DOQI guide, in an attempt to identify whether MMP-9 levels in T2DM differ in patients with and without renal impairment. Univariate and multivariable analyses were performed in order to identify the association between MMP-9 and renal impairment. Results Included in the study were 34 (45%) subjects with renal impairment and 42 (55%) without. In the group with renal impairment, 10 subjects corresponded to stages 1–2 and 24 subjects corresponded to stage 3, according to their values of GFR and urinary albumin, following that proposed by the K/DOQI. No differences were found relating to sex, age, having or not having a partner, education, being able to read and write a message and duration of T2DM. Moreover, no differences were found between the groups in terms of weight, height, body mass index, waist size in general and frequency of UTI. In contrast, serum creatinine and urinary albumin were higher in the group with renal impairment, while GFR was greater in the group without renal impairment. Levels of MMP-9 were greater in women compared to men. Through univariate analysis in the general population, the presence of MMP-9 and that of its percentile 90 (P90) P90 were associated with the renal impairment group; however, in patients without UTI, only the presence of MMP-9 was associated with the renal impairment group, and no association was found with its P90. Multivariate analysis revealed an association between MMP-9 and its P90 with renal impairment. Discussion It is necessary to validate sensitive and non-invasive biological markers of CKD. We demonstrate that the presence and P90 of urinary MMP-9 are associated with renal impairment in Mexican patients with T2DM. While high levels of MMP-9 were associated to females and UTI, the presence of UTI was not associated with the incidence of renal impairment.

scholarly journals Effect of Curcumin on Diabetic Kidney Disease: A Systematic Review and Meta-Analysis of Randomized, Double-Blind, Placebo-Controlled Clinical Trials

2021 ◽  
Vol 2021 ◽  
pp. 1-14
Author(s):  
Zhao Jie ◽  
Mo Chao ◽  
Ai Jun ◽  
Shi Wei ◽  
Meng LiFeng
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Kidney Disease ◽  
Diabetic Kidney Disease ◽  
Meta Analysis ◽  
Fasting Blood Glucose ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Cochrane Library ◽  
Diabetic Kidney

Background. Curcumin, a polyphenolic constituent from Curcuma longa, possesses antioxidant, hypolipidemic, and antidiabetic properties and has been reported to protect against diabetic kidney disease (DKD); however, the effect is inconsistent. Objective. This systematic review and meta-analysis aimed to investigate the effect of curcumin supplementation on renal function, lipid profile, blood pressure, and glycemic control in DKD. Methods. A systematic and comprehensive literature search of interrelated randomized controlled trials (RCTs) was conducted in PubMed, Embase, Cochrane Library, Web of Science, Scopus, and ClinicalTrials.gov from inception to July 30, 2021. Two investigators independently extracted data and assessed the risk of bias. Weighted mean differences (WMDs) with 95% confidence intervals (CIs) were calculated to describe the effect sizes using a fixed-effect model. Statistical analysis was performed using STATA 14.0 and RevMan 5.3. Results. Five RCTs involving 290 participants with DKD were included. Curcumin supplementation significantly improved the serum creatinine (WMD: −0.16 mg/dL, 95% CI: −0.3 to −0.02, P  = 0.029, I2 = 0%, moderate certainty), total cholesterol (WMD: −10.13 mg/dL, 95% CI: −17.84 to −2.14, P  = 0.01, I2 = 0%, moderate certainty), systolic blood pressure (WMD: 3.94 mmHg, 95% CI: 1.86 to 6.01, P  < 0.01, I2 = 33.5%, moderate certainty), and fasting blood glucose (WMD: −8.29 mg/dL, 95% CI: −15.19 to −1.39, P  = 0.019, I2 = 43.7%, moderate certainty) levels; however, it had no significant effects on blood urea nitrogen, proteinuria, triglyceride, low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol, and diastolic blood pressure levels. Conclusions. Curcumin may provide great potential effects against DKD. More large-scale and high-quality RCTs are required to confirm these findings.

scholarly journals A systematic review and meta‐analysis of cell‐based interventions in experimental diabetic kidney disease

2021 ◽  
Author(s):  
LaTonya J. Hickson ◽  
Tala Abedalqader ◽  
Gift Ben‐Bernard ◽  
Jayla M. Mondy ◽  
Xiaohui Bian ◽  
...  
Keyword(s):  
Systematic Review ◽  
Kidney Disease ◽  
Diabetic Kidney Disease ◽  
Meta Analysis ◽  
Diabetic Kidney

scholarly journals Administration of mesenchymal stem cells in diabetic kidney disease: a systematic review and meta-analysis

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Wenshan Lin ◽  
Hong-Yan Li ◽  
Qian Yang ◽  
Guangyong Chen ◽  
Shujun Lin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Kidney Disease ◽  
Diabetic Kidney Disease ◽  
Meta Analysis ◽  
Treated Group ◽  
Hypoglycemic Effect ◽  
Cochrane Library ◽  
Great Promise ◽  
Therapeutic Effects ◽  
Diabetic Kidney

Abstract Background Mesenchymal stem cell (MSC) therapy shows great promise for diabetic kidney disease (DKD) patients. Research has been carried out on this topic in recent years. The main goals of this paper are to evaluate the therapeutic effects of MSCs on DKD through a meta-analysis and address the mechanism through a systematic review of the literature. Method An electronic search of the Embase, Cochrane Library, ISI Web of Science, PubMed, and US National Library of Medicine (NLM) databases was performed for all articles about MSC therapy for DKD, without species limitations, up to January 2020. Data were pooled for analysis with Stata SE 12. Result The MSC-treated group showed a large and statistically significant hypoglycemic effect at 1 week, 2 weeks, 3 weeks, 1 month, 2 months, 3 months, and 6 months. Total hypoglycemic effect was observed (SMD = − 1.954, 95%CI − 2.389 to − 1.519, p < 0.001; I2 = 85.1%). The overall effects on serum creatinine (SCr) and blood urea nitrogen (BUN) were analyzed, suggesting that MSC decreased SCr and BUN and mitigated the impairment of renal function (SCr: SMD = − 4.838, 95%CI − 6.789 to − 2.887, p < 0.001; I2 = 90.8%; BUN: SMD = − 4.912, 95%CI − 6.402 to − 3.422, p < 0.001; I2 = 89.3%). Furthermore, MSC therapy decreased the excretion of urinary albumin. Fibrosis indicators were assessed, and the results showed that transforming growth factor-β, collagen I, fibronectin, and α-smooth muscle actin were significantly decreased in the MSC-treated group compared to the control group. Conclusion MSCs might improve glycemic control and reduce SCr, BUN, and urinary protein. MSCs can also alleviate renal fibrosis. MSC therapy might be a potential treatment for DKD.

scholarly journals Administration of Mesenchymal Stem Cells in Diabetic Kidney Disease: A Systematic Review and Meta-analysis

2020 ◽  
Author(s):  
Wenshan Lin ◽  
Qian Yang ◽  
Guangyong Chen ◽  
Shujun Lin ◽  
Chunling Liao ◽  
...  
Keyword(s):  
Systematic Review ◽  
Kidney Disease ◽  
Diabetic Kidney Disease ◽  
Meta Analysis ◽  
Treated Group ◽  
Hypoglycemic Effect ◽  
Cochrane Library ◽  
Great Promise ◽  
Therapeutic Effects ◽  
Diabetic Kidney

Abstract Background: Mesenchymal stem cell (MSC) therapy shows great promise for diabetic kidney disease (DKD) patients. Research has been carried out on this topic in recent years. The main goal of this paper is to evaluate the therapeutic effects of MSCs on DKD through a meta-analysis and address the mechanism through a systematic review of the literature.Method: An electronic search of the Embase, Cochrane Library, ISI Web of Science, PubMed and U.S National Library of Medicine (NLM) databases was performed for all articles about MSC therapy for DKD, without species limitations, up to January 2020. Data were pooled for analysis with Stata SE 12.Result: The MSC-treated group showed a large and statistically significant hypoglycemic effect at 1 week, 2 weeks, 3 weeks, 1 month, 2 months, 3 months and 6 months. Total hypoglycemic effect was observed (SMD=-1.954, 95%CI: -2.389 to -1.519, p＜0.001). The overall effects on serum creatinine (SCr) and blood urea nitrogen (BUN) were analyzed, suggesting that MSC decreased SCr and BUN and mitigated the impairment of renal function (SCr: SMD= -4.838, 95%CI: -6.789 to -2.887, p＜0.001; BUN: SMD= -4.912, 95%CI: -6.402 to -3.422, p＜0.001). Furthermore, MSC therapy decreased the excretion of urinary albumin. Fibrosis indicators were assessed, and the results showed that transforming growth factor-β, collagen-I, fibronectin and α-smooth muscle actin were significantly decreased in the MSC-treated group compared to the control group.Conclusion: MSCs may improve glycemic control and reduce SCr, BUN, and urinary protein. MSCs can also alleviate renal fibrosis. MSC therapy is a potential treatment for DKD.

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