The effect of the components of the renin-angiotensinaldosterone system on the development of diabetic nephropathy in type 1 diabetes (review)

2021 ◽  
Vol 25 (2) ◽  
pp. 43-51
Author(s):  
K. V. Skobeleva ◽  
L. V. Tyrtova

One of the key roles in the development of diabetic nephropathy belongs to the renin-angiotensin-aldosterone system (RAAS), which is involved in the regulation of hemodynamics, systemic and intrarenal pressure, production of profibrogenic and growth factors, vascular remodeling. At the end of the twentieth century, local (tissue) RAAS elements from renin to aldosterone were found in tissues and target organs (including kidneys). Tissue RAAS plays a leading role in the development of vascular complications of diabetes mellitus (DM): cardiovascular disease, diabetic nephropathy, and retinopathy. It is this fact that explains in many ways the pathogenetic role of RAAS in the defeat of target organs even with normal or low plasma renin activity (ARP). RAAS activation occurs long before the clinical signs of diabetic nephropathy, which makes it possible for earlier prevention and correction of initial changes in the study of its components, as well as reducing disability and the output of patients in chronic kidney disease. Given the tendency to “rejuvenate” diabetes mellitus, the lability of the course of the disease in childhood, the high hormonal activity in this group of patients, and, therefore, the greater the risk of complications, the timely diagnosis of the initial manifestations of DN is of high relevance and relevance.

2018 ◽  
Vol 56 (2) ◽  
pp. 151-161 ◽  
Author(s):  
Rosario Caruso ◽  
Paola Rebora ◽  
Federica Dellafiore ◽  
Diletta Fabrizi ◽  
Barbara Riegel ◽  
...  

2021 ◽  
pp. 9-20
Author(s):  
Arus Garikovna Margaryan ◽  
Svetlana Anatolievna Lebedeva ◽  
Dariya Mikhailovna Lisitsyna ◽  
Polina Igorevna Sirotkina ◽  
Lyudmila Aleksandrovna Yakubova ◽  
...  

The diabetic kidney disease (also known as diabetic nephropathy) is a major complication of diabetes mellitus and also the most common cause of chronic kidney disease. Elevated plasma levels of vasopressin are consistently observed in patients with either type 1 and type 2 diabetes mellitus and in animal models of diabetes mellitus. A role of enhanced vasopressin signaling in progression of the diabetic nephropathy to chronic kidney disease has been suggested in several epidemiological studies but the underlying pathogenetic mechanisms remain largely unclear and are the subject of current scientific research.


2018 ◽  
Vol 25 (14) ◽  
pp. 1502-1519 ◽  
Author(s):  
Rinkoo Dalan ◽  
Goh Liuh Ling

Introduction and background Haptoglobin (Hp) is considered to be an antioxidant and protective against cardiovascular complications. Polymorphisms in the Hp gene interact with diabetes mellitus to affect the risk of vascular complications. Methods We review the updated literature about the protean role of Hp and Hp genotypes spanning genomics, molecular, translational and clinical studies. We searched Pubmed, SCOPUS and Google Scholar for all articles using the keywords: haptoglobin and/or haptoglobin polymorphism and diabetes. We review the diverse Hp genotypes, phenotypes and the impact on diabetes complications, including lessons from animal models and in vitro models. We describe the clinical studies on the associations of Hp genotypes with vascular complications in type 1 and type 2 diabetes comprehensively. We review the studies looking at vitamin E supplementation in a personalized manner in Hp2-2 diabetes individuals. Results and conclusion Hp genotypes have evolved as a result of deletions in the traditional Hp genes. The Hp genotypes have been associated with microvascular and macrovascular complications in type 1 diabetes mellitus but the association in type 2 diabetes is more consistent with cardiovascular complications. A preferential benefit of vitamin E and other antioxidants in the Hp2-2 genotype for cardiovascular complications in type 2 diabetes has been seen presumably secondary to interaction with high-density lipoprotein function. Hence, the Hp genotype can be used to personalize antioxidant therapeutics in diabetes patients. These results need to be corroborated in large, global, pragmatic, prospective, cardiovascular outcome trials in type 2 diabetes patients.


Author(s):  
O.I. Terekhova

Nowadays diabetes mellitus is one of the global problems. Due to insufficiently effective treatment, diabetes can significantly worsen the life of patients, which leads to early disability and premature death caused by vascular complications. Today, it is clear that diabetic complications not only develop more often in patients who fell ill in their childhood, but also are widespread among adolescents. The purpose of the paper is to study the prevalence of diabetic nephropathy among children and adolescents in the Kyrgyz Republic. Materials and Methods. The authors examined 131 children, hospitalized to the Department of Endocrinology, the National Center for Maternity and Childhood Protection between January 2017 and December 2018 and diagnosed with diabetes mellitus, type 1. The results were processed by variation statistics technique using the statistical analysis software package (Statistica for Windows v. 6.0). Results. Diabetic nephropathy was detected in 60 patients (46 %). Complications were observed more often in children from Bishkek (28 %). Data analysis showed that boys prevailed (62 % boys and 38 % girls). The frequency of diabetic nephropathy directly depended on the age of the patient during examination. The critical age for patients was 15–17 years old, since at thats age the transition of diabetic nephropathy from its latent form to clinically expressed stages III and IV was observed. Conclusions. Diabetic nephropathy is rarely diagnosed in children under 10 years of age and in case of diabetes duration up to 3 years; puberty is one of the leading risk factors in its development; the transition from functional to clinical stages occurs at the age of 12–17 and in case of diabetes duration for 12–15 years. Keywords: children and adolescents, diabetic nephropathy, diabetes mellitus. Сахарный диабет представляет собой одну из глобальных проблем современности. Часто при недостаточно эффективном лечении диабет может значительно ухудшить жизнь пациентов, что приводит к ранней инвалидизации и преждевременной смерти из-за развития сосудистых осложнений. На сегодняшний день достоверно установлено, что диабетические осложнения не только чаще развиваются у пациентов, заболевших в детстве, но и имеют широкую распространенность среди детей подросткового возраста. Цель исследования – изучить распространенность диабетической нефропатии среди детей и подростков в Кыргызской Республике. Материалы и методы. Был обследован 131 ребенок, госпитализированный в отделение эндокринологии Национального центра охраны материнства и детства (НЦОМиД) в период с января 2017 г. по декабрь 2018 г. с диагнозом «сахарный диабет 1 типа». Материалы и методы. Результаты обработаны методом вариационной статистики с использованием стандартного пакета программ прикладного статистического анализа (Statistica for Windows v. 6.0). Результаты. Диабетическая нефропатия выявлена у 60 больных, что составляет 46 % от общего числа обследованных. Чаще дети с осложнениями в отделение поступали из г. Бишкека (28 %). Анализ данных показал, что мальчиков было 62 %, а девочек – 38 %. Частота выявления диабетической нефропатии находилась в прямой зависимости от возраста больного в момент обследования. Возраст 15–17 лет является критическим для больного, так как в это время происходит переход диабетической нефропатии из ее скрытой формы в клинически выраженные III и IV стадии. Выводы. Диабетическая нефропатия редко диагностируется у детей до 10-летнего возраста и при длительности течения диабета до трех лет; пубертатный период является одним из ведущих факторов риска ее развития; переход от функциональных к клиническим стадиям происходит в возрасте 12–17 лет и при длительности течения диабета 12–15 лет. Ключевые слова: дети и подростки, диабетическая нефропатия, сахарный диабет.


2011 ◽  
Vol 14 (1) ◽  
pp. 81-88 ◽  
Author(s):  
Marina Vladimirovna Shestakova ◽  
Minara Shamkhalovna Shamkhalova ◽  
Ivona Yanovna Yarek-Martynova ◽  
Inna Igorevna Klefortova ◽  
Olga Yur'evna Sukhareva ◽  
...  

The dramatic increase in the number of patients with diabetes mellitus (DM) and chronic renal disease (CRD) in the recent years emphasizes the closeassociation between the two conditions and the leading role of DM in the development of renal pathology. Diabetology and nephrology are highly costlybranches of public health, and the burden of substitution renal therapy in DM patients continues to grow. The necessity of a renoprotection programat the early stages of DM for the prevention or delay of terminal renal insufficiency becomes increasingly clear. Such program should be based on theconceptual model of the evolvement of diabetic nephropathy as a consequence of combined action of metabolic and hemodynamic factors modulatedby genetic ones.


2019 ◽  
Author(s):  
Karina Sarkisova ◽  
Iwona-Renata Jarek-Martynowa ◽  
Marina Shestakova ◽  
Minara Shamkhalova ◽  
Alexander Parfenov

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