scholarly journals Metformin Protects against Podocyte Injury in Diabetic Kidney Disease

2020 ◽  
Vol 13 (12) ◽  
pp. 452
Author(s):  
Sanna Lehtonen

Metformin is the most commonly prescribed drug for treating type 2 diabetes mellitus (T2D). Its mechanisms of action have been under extensive investigation, revealing that it has multiple cellular targets, either direct or indirect ones, via which it regulates numerous cellular pathways. Diabetic kidney disease (DKD), the serious complication of T2D, develops in up to 50% of the individuals with T2D. Various mechanisms contribute to the development of DKD, including hyperglycaemia, dyslipidemia, oxidative stress, chronic low-grade inflammation, altered autophagic activity and insulin resistance, among others. Metformin has been shown to affect these pathways, and thus, it could slow down or prevent the progression of DKD. Despite several animal studies demonstrating the renoprotective effects of metformin, there is no concrete evidence in clinical settings. This review summarizes the renoprotective effects of metformin in experimental settings. Special emphasis is on the effects of metformin on podocytes, the glomerular epithelial cells that are central in maintaining the glomerular ultrafiltration function.

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 443-P
Author(s):  
YOSHINORI KAKUTANI ◽  
MASANORI EMOTO ◽  
YUKO YAMAZAKI ◽  
KOKA MOTOYAMA ◽  
TOMOAKI MORIOKA ◽  
...  

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 539-P
Author(s):  
YOSHINORI KAKUTANI ◽  
MASANORI EMOTO ◽  
KATSUHITO MORI ◽  
YUKO YAMAZAKI ◽  
AKINOBU OCHI ◽  
...  

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Randa I. Farah ◽  
Mohammed Q. Al-Sabbagh ◽  
Munther S. Momani ◽  
Asma Albtoosh ◽  
Majd Arabiat ◽  
...  

Abstract Aim Diabetic kidney disease (DKD) is a major long-term complication of diabetes mellitus (DM). Given the paucity of data on DKD in Jordan, we aimed to evaluate the prevalence, characteristics and correlates of DKD in Jordanian patients with type 2 DM. Methods This cross-sectional study included 1398 adult patients with type 2 DM who sought medical advice in the endocrinology clinic between March and September 2019. Demographic, clinical and laboratory data were reviewed. DKD was defined as reduced eGFR, and/or albuminuria. Three regression models were constructed to identify factors associated with CKD stages, albuminuria and DKD. Results Overall, 701 (50.14%) patients had DKD, with a median age of 59.71 ± 11.36  years. Older age, high triglycerides, and low high-density lipoprotein were associated with DKD (multivariable odds ratio [OR]: 1.02, 95% confidence interval [CI]: 1.01–1.03, p < 0.01; OR: 1.1, 95% CI: 1.01–1.2; and OR: 0.98, 95% CI: 0.97–0.99, p < 0.01 respectively). Metformin and renin-angiotensin system blockers were negatively associated with albuminuria and chronic kidney disease stages (p < 0.01). Conclusion Our study demonstrated that approximately one half of patients with type 2 DM had DKD. Further studies are necessary to understand this high prevalence and the underlying factors. Future research are needed to assess implementing targeted community-based intervention.


2019 ◽  
Vol 95 (1) ◽  
pp. 178-187 ◽  
Author(s):  
Guozhi Jiang ◽  
Andrea On Yan Luk ◽  
Claudia Ha Ting Tam ◽  
Fangying Xie ◽  
Bendix Carstensen ◽  
...  

2021 ◽  
Vol 18 (3) ◽  
pp. 17-25
Author(s):  
Stoiţă Marcel ◽  
Popa Amorin Remus

Abstract The presence of albuminuria in patients with type 2 diabetes mellitus is a marker of endothelial dysfunction and also one of the criteria for diagnosing diabetic kidney disease. The present study aimed to identify associations between cardiovascular risk factors and renal albumin excretion in a group of 218 patients with type 2 diabetes mellitus. HbA1c values, systolic blood pressure, diastolic blood pressure were statistically significantly higher in patients with microalbuinuria or macroalbuminuria compared to patients with normoalbuminuria (p <0.01). We identified a statistically significant positive association between uric acid values and albuminuria, respectively 25- (OH)2 vitamin D3 deficiency and microalbuminuria (p <0.01).


2008 ◽  
Vol 11 (4) ◽  
pp. 988-991
Author(s):  
Robert C Atkins ◽  
Paul Zimmet

In 2003, the International Society of Nephrology and the International Diabetes Federation launched a booklet called “Diabetes in the Kidney: Time to act” [1] to highlight the global pandemic of type 2 diabetes and diabetic kidney disease. ration (PZ)


Author(s):  
Denisha R Spires ◽  
Oleg Palygin ◽  
Vladislav Levchenko ◽  
Elena Isaeva ◽  
Christine A. Klemens ◽  
...  

Diabetic kidney disease (DKD) is a common complication of diabetes, which frequently leads to end-stage renal failure and increases cardiovascular disease risk. Hyperglycemia promotes renal pathologies such as glomerulosclerosis, tubular hypertrophy, microalbuminuria, and a decline in glomerular filtration rate. Importantly, recent clinical data have demonstrated distinct sexual dimorphism in the pathogenesis of DKD in people with diabetes, which impacts both severity- and age-related risk factors. This study aimed to define sexual dimorphism and renal function in a non-obese type 2 diabetes model with the spontaneous development of advanced diabetic nephropathy (T2DN rats). T2DN rats at 12- and over 48-weeks old were used to define disease progression and kidney injury development. We found impaired glucose tolerance and glomerular hyperfiltration in T2DN rats to compare with non-diabetic Wistar control. The T2DN rat displays a significant sexual dimorphism in insulin resistance, plasma cholesterol, renal and glomerular injury, urinary nephrin shedding, and albumin handling. Our results indicate that both male and female T2DN rats developed non-obese type 2 DKD phenotype, where the females had significant protection from the development of severe forms of DKD. Our findings provide further evidence for the T2DN rat strain's effectiveness for studying the multiple facets of DKD.


2021 ◽  
Vol 8 (2) ◽  
pp. 112-119
Author(s):  
Juju Raj Shrestha ◽  
Kashyap Dahal ◽  
Anil Baral ◽  
Rajani Hada

Introduction: Non diabetic kidney disease (NDKD), a treatable condition, is common in diabetic patients with atypical clinical presentations. Present study aimed to find out histopathological diagnosis of kidney disease in type 2 Diabetes mellitus with such presentations. Method: This was a hospital based cross sectional study conducted in Nephrology department, Bir hospital, Nepal from Aug 2019 to January 2021. Total 29 diabetic patients with atypical presentations, rapid rise of proteinuria alone (n=5), with microscopic hematuria (n=6), with impaired renal function (n=8) and rapid rise of creatinine with (n=8) or without (n=2) microscopic hematuria were included. The baseline information was recorded and kidney biopsy was performed. Result: The mean age of patients was 52.6±10.4 y and 22(75.9%) were male. Diabetic retinopathy (DR) was absent in 24(82.8%) patients. Presence of NDKD alone was in 6(20.7%) and superimposed on diabetic kidney disease (DKD) in 10(34.5%) with total NDKD in 16(55.2%) and isolated DKD in 13(44.8%) patients. Non diabetic kidney disease were glomerulonephritis 12(75%) with membranous nephropathy 4(25%) and IgA nephropathy 4(25%) patients. The significant difference between NDKD and isolated DKD was only the duration of diabetes < 5 y in 8(61.5%) of isolated DKD and ≥5 y in 13(81.2%) patients with NDKD (p=0.018). Diabetic retinopathy was absent in 6(100%) patients with isolated NDKD, 8(80%) of class III and 5(62.5%) of class IV DKD. Conclusion: Glomerulonephritis is the commonest NDKD in type 2 DM with atypical presentation and advance DKD (Class III & IV) is present even in absence of diabetic retinopathy and short duration of diabetes.


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