scholarly journals Acute Kidney Injury in Pediatric Diabetic Kidney Disease

2021 ◽  
Vol 9 ◽  
Author(s):  
Federica Piani ◽  
Trenton Reinicke ◽  
Claudio Borghi ◽  
Kalie L. Tommerdahl ◽  
Gabriel Cara-Fuentes ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Diabetic Kidney Disease ◽  
Kidney Injury ◽  
Public Health Problem ◽  
Therapeutic Interventions ◽  
Diabetic Kidney ◽  
Significant Public Health ◽  
The Impact

Diabetic kidney disease (DKD) is a common complication of type 1 and 2 diabetes and often presents during adolescence and young adulthood. Given the growing incidence of both type 1 and type 2 diabetes in children and adolescents, DKD represents a significant public health problem. Acute kidney injury (AKI) in youth with diabetes is strongly associated with risk of DKD development. This review will summarize the epidemiology and pathophysiology of AKI in children with diabetes, the relationship between AKI and DKD, and the potential therapeutic interventions. Finally, we will appraise the impact of the recent COVID-19 infection pandemic on AKI in children with diabetes.

scholarly journals Acute Kidney Injury and Progressive Diabetic Kidney Disease: An Epidemiological Perspective

2021 ◽  
Vol Volume 14 ◽  
pp. 23-31 ◽  
Author(s):  
Ravindra Attur Prabhu ◽  
Srinivas V Shenoy ◽  
Shankar Prasad Nagaraju ◽  
Dharshan Rangaswamy ◽  
Indu Ramachandra Rao ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Diabetic Kidney Disease ◽  
Kidney Injury ◽  
Diabetic Kidney

scholarly journals Chinese Herbal Medicine in Ameliorating Diabetic Kidney Disease via Activating Autophagy

2019 ◽  
Vol 2019 ◽  
pp. 1-10
Author(s):  
Yuyang Wang ◽  
Hailing Zhao ◽  
Qian Wang ◽  
Xuefeng Zhou ◽  
Xiaoguang Lu ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Herbal Medicine ◽  
Chinese Herbal Medicine ◽  
Diabetic Kidney Disease ◽  
Kidney Injury ◽  
Public Health Problem ◽  
Current Status ◽  
Diabetic Patients ◽  
Diabetic Kidney ◽  
Chinese Herbal

Diabetic kidney disease (DKD), a leading cause of end-stage renal disease (ESRD), has become a serious public health problem worldwide and lacks effective therapies due to its complex pathogenesis. Recent studies suggested defective autophagy involved in the pathogenesis and progression of DKD. Chinese herbal medicine, as an emerging option for the treatment of DKD, could improve diabetic kidney injury by activating autophagy. In this review, we briefly summarize underlying mechanisms of autophagy dysregulation in DKD, including AMP-activated protein kinase (AMPK), the mechanistic target of rapamycin (mTOR), and the sirtuin (Sirt) pathways, and we particularly concentrate on the current status of Chinese herbal medicine treating DKD by regulating autophagy. The advances in our understanding regarding the treatment of DKD via regulating autophagy with Chinese herbal medicine will enhance the clinical application of Chinese medicine as well as discovery of novel therapeutic agents for diabetic patients.

scholarly journals Mannan-Binding Lectin in Diabetic Kidney Disease: The Impact of Mouse Genetics in a Type 1 Diabetes Model

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Jakob Appel Østergaard ◽  
Mette Bjerre ◽  
Satish Posettihalli RamachandraRao ◽  
Kumar Sharma ◽  
Jens Randel Nyengaard ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Diabetic Nephropathy ◽  
Kidney Disease ◽  
Genetic Background ◽  
Diabetic Kidney Disease ◽  
Diabetic Kidney ◽  
Mannan Binding Lectin ◽  
The Impact ◽  
Binding Lectin

Background. Mannan-binding lectin (MBL) is involved in the development of diabetic nephropathy. MBL is a part of the innate immune system where it can activate the complement system. Serum MBL level predicts later renal impairment in diabetes patients. Direct involvement of MBL in the development of diabetic kidney disease is observed in one animal strain. However, this involvement may differ among the animal strains. We thus examined the impact of the genetic background on the role of MBL in diabetic nephropathy.Materials/Methods. C57BL/6JBomTac and 129S6/SvEvTac mice were compared. In both strains, experimental type 1 diabetes was induced in wild-type (WT) and MBL-knockout (MBL-KO) mice by streptozotocin. Nondiabetic WT and MBL-KO mice were used as controls. We tested if MBL modified the diabetes-induced kidney changes by two-way ANOVA allowing for interaction.Results. MBL aggravated diabetes-induced kidney growth and glomerulus enlargement in C57BL/6JBomTac mice. MBL did not modify diabetes effects on glomerular basement membrane thickness or mesangial volume in any strain. Diabetes-induced changes in renal gene transcription of growth factors and matrix components were unaffected by MBL.Conclusions. Strain-specific MBL effects were found on downstream diabetic kidney changes. This emphasizes the importance of genetic background in this model of diabetic complications.

MO637THE HIDDEN PREVALENCE OF DIABETIC KIDNEY DISEASE IN A HOSPITAL-BASED REAL-WORLD DATA ANALYSIS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Maria Marques Vidas ◽  
Alba Maroto ◽  
Ester Domenech ◽  
Paula López ◽  
Fernando Tornero Molina ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Diabetic Kidney Disease ◽  
Severe Disease ◽  
Laboratory Data ◽  
Kidney Injury ◽  
Therapeutic Interventions ◽  
Correct Identification ◽  
Creatinine Ratio ◽  
Real World Data ◽  
Diabetic Kidney

Abstract Background and Aims Correct identification of diabetic kidney disease (DKD) in type 2 diabetes mellitus (T2DM) patients is crucial to implement therapeutic interventions to prevent disease progression and premature death. Method We have analyzed the prevalence of DKD according to lab criteria and the rate of identification of DKD and/or chronic kidney disease (CKD) on 516,578 hospital care electronic medical records (EMR) in a tertiary hospital-based population using Savana Manager®. Results Out of 24,129 T2DM patients, 15,304 met inclusion criteria. DKD was defined as eGFR<60 ml/min/1.73m2 or urinary albumin to creatinine ratio (UACR) >30 mg/g or urinary protein to creatinine ratio (UPCR) >0.3 g/g after excluding acute kidney injury (AKI). A total of 4,526 (29.6%) T2DM patients had DKD according to lab criteria. However, the terms “CKD” or “DKD” were only present in 33.1% and 7.5% of the 4,526 EMR, with a hidden prevalence of CKD and DKD of 66.9% and 92.5%, respectively. Less severe kidney disease (lower UACR or UPCR, higher eGFR values), female sex, and lack of insulin prescription were associated with the absence of “DKD” or “CKD” terms in EMR (p<0.001) in the patients fulfilling laboratory criteria for DKD. However, while younger age (<70 years) was associated with a missing CKD diagnosis, older age (≥70 years) was associated with a missing DKD diagnosis in EMR. Conclusion In conclusion, the prevalence of DKD among T2DM patients according to laboratory data is higher than prevalence based on specific diagnosis written in EMR. This could imply underdiagnosis of DKD, especially in patients with less severe disease who may benefit the most from optimized therapy

scholarly journals Cardiovascular autonomic neuropathy and the impact on progression of diabetic kidney disease in type 1 diabetes

2021 ◽  
Vol 9 (1) ◽  
pp. e002289
Author(s):  
Theis Bjerre-Christensen ◽  
Signe A Winther ◽  
Nete Tofte ◽  
Simone Theilade ◽  
Tarunveer S Ahluwalia ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Kidney Disease ◽  
Autonomic Neuropathy ◽  
Diabetic Kidney Disease ◽  
Cox Regression ◽  
Cardiovascular Autonomic Neuropathy ◽  
Diabetic Kidney ◽  
Yearly Change ◽  
The Impact

IntroductionWe investigated the association between cardiovascular autonomic neuropathy (CAN) and decline in kidney function in type 1 diabetes.Research design and methodsWe included 329 persons with type 1 diabetes. CAN was assessed by cardiovascular reflex tests (CARTs): heart rate response to deep breathing (E/I ratio), to standing (30/15 ratio) and to the Valsalva maneuvre. Two or more pathological CARTs defined CAN diagnosis. Outcomes were yearly change in albuminuria or yearly change in estimated glomerular filtration rate (eGFR). An endpoint of eGFR decline >30%, development of end-stage kidney disease (ESKD) or death was examined.Associations were assessed by linear and Cox regression.ResultsParticipants were aged 55.2 (9.4) years, 52% were male, with a diabetes duration of 40.1 (8.9) years, HbA1c of 7.9% (62.5 mmol/mol), eGFR 77.9 (27.7) mL/min/1.73 m2, urinary albumin excretion rate of 14.5 (7–58) mg/24 hours, and 31% were diagnosed with CAN.CAN was associated with a 7.8% higher albuminuria increase per year (95% CI: 0.50% to 15.63%, p=0.036) versus no CAN. The endpoint of ESKD, all-cause mortality and ≥30% decline in eGFR was associated with CAN (HR=2.497, p=0.0254).ConclusionCAN and sympathetic dysfunction were associated with increase in albuminuria in individuals with type 1 diabetes suggesting its role as a potential marker of diabetic kidney disease progression.

scholarly journals Therapeutic Strategies for Diabetic Kidney Disease

Diabetology ◽  
2021 ◽  
Vol 2 (1) ◽  
pp. 31-35
Author(s):  
Keiichiro Matoba
Keyword(s):  
Kidney Disease ◽  
Diabetic Kidney Disease ◽  
Intensive Therapy ◽  
Therapeutic Strategies ◽  
Therapeutic Interventions ◽  
Hemodynamic Changes ◽  
Diabetic Kidney ◽  
Global Epidemic ◽  
Stage Renal Disease ◽  
End Stage

Diabetic kidney disease (DKD) is a global epidemic leading to end-stage renal disease (ESRD) and susceptibility to cardiovascular disease, with few therapeutic interventions. A hallmark of DKD is the activation of the renin-angiotensin-aldosterone system and hemodynamic changes in glomerulus. Although intensive therapy with agents that targets those abnormalities lowers the risk of DKD progression, it does not completely abolish the risk of ESRD and cardiovascular events. Recent studies have illustrated the importance of renal inflammation, oxidative stress, and activated Rho-associated protein kinase (ROCK) signaling as essential pathogenesis for the development of DKD. In this commentary, these topics will be discussed.

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