A special issue on from bench to bedside: An integrated and multidisciplinary approach to tackling diabetic kidney disease DOI Open Access
Janaka Karalliedde, Claire E. Hills

Diabetic Medicine, Journal Year: 2024, Volume and Issue: unknown

Published: Dec. 15, 2024

More than 800 million people have chronic kidney disease (CKD) globally and type 2 diabetes accounts for between 30% 50% of cases CKD.1 Diabetic Kidney (DKD) is associated with increased cardiovascular (CVD) morbidity mortality in many countries also the leading cause end stage needing replacement therapy (dialysis or transplantation).2 DKD impacts on length quality life significantly contributes to global healthcare expenditure these human economic costs are likely rise further future.2, 3 Prognosis progression can differ from one individual another, which often a consequence interactions traditional emerging risk factors as well social-demographic factors, such ethnicity socio-economic factors.4 The recent Research UK health inequalities report demonstrated that South Asian Black backgrounds three five times more require dialysis white background.5 This observation may be part linked increasing prevalence currently unknown determinants progression. management requires multifactorial multidisciplinary approach key focus early identification CKD screening then prompt intervention focussing important lifestyle modifications, using evidence-based medical treatments holistic care.3, 6 With advances pillars treatment includes renin angiotensin system inhibition, sodium glucose co-transporter inhibition (SGLT2-inh), non-steroidal mineralocorticoid receptor antagonists glucagon like peptide 1 agonists (GLP-1 RA) parallel CVD factor modification, there an opportunity intervene change risk.7, 8 For DKD, gaps care options limited contrast diabetes, indeed, high burden this cohort underappreciated.9 natural history has evolved over last 40 years, remains significant residual ESKD premature CVD.9, 10 Despite 30 not optimal present late when modifiability progression/risk less feasible. There thus urgent need better methods biomarkers aid stratification ensure those at highest recognized guideline directed therapies initiated promptly morbidity/mortality.8, 11 glycaemic control challenging setting individualized approach. pathophysiology multifaceted encompasses metabolic haemodynamic perturbations lead structural functional disturbances including glomerular hyper-filtration, mesangial expansion interstitial fibrosis, convergence fundamental mechanisms, 'sterile' inflammation age changes, example cell senescence.12, 13 Although precise role development unclear, studies suggest accelerated ageing phenotype, coupled maladaptive immune response, underlies Furthermore, coexistence disease, so called 'cardiorenal syndrome', occurs face multi-organ crosstalk, evidence suggesting systemic vascular robust predictor poor dyslipidaemia. As obesity, syndrome continue rise, major worldwide. A understanding interrelationships crosstalk different organs/systems contributing complications will enhance scientific could facilitate new interventions prevent treat diabetes-related co-morbidities. mechanisms underpin clinical benefits existing therapies, GLPRA SGLT2i, inform how why drug works both within inter-organ cardiovascular-kidney-metabolic other secondary diabetes. special issue diabetic medicine focussed basic translational research, potential therapeutic targets,12-15 changing diabetes,10 scenarios,11 guidelines their implementation day-to-day patient practice.16 We hope readers enjoy reading collection articles apply related learning drive future research help improve outcomes DKD. None. authors declare no conflicts interest.

Language: Английский

Prevalence of and Factors Associated With Incidental Chronic Kidney Disease in Patients Newly Diagnosed With Type 2 Diabetes Mellitus DOI Open Access

Duha Ayad Alidrisi,

Haider A Alidrisi,

Khulood A Reman

et al.

Cureus, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 18, 2025

Objective: The objective of this study was to detect the prevalence incidental chronic kidney disease (CKD) in patients newly diagnosed with type 2 diabetes (T2D). Method: This a cross-sectional conducted from July 2023 November 2024, at Faiha Specialized Diabetes, Endocrine, and Metabolism Center Al-Rafidain Basrah, southern Iraq. A total 202 drug-naïve T2D were included. baseline clinical biochemical characteristics for inclusion. CKD by measuring estimated glomerular filtration rate (eGFR) urine albumin creatinine ratio (UACR). Results: mean age included 49.1±12 years. 68 (33.7%) based on GFR <60 mL/minute/1.73 m2 and/or UACR ≥ 30 mg/g. categories G1, 2, G3a, 3b prevalent 71.3%, 24.2%, 3.0%, 1.5%, respectively. For albuminuria, 31.2% had 10-30 mg/g, 22.8% 30-300 7.9% higher than 300 stepwise binary regression analysis showed that patients' HbA1c levels factors significantly associated CKD. Conclusion: is one-third T2D. Early screening highly recommended as it will affect overall management.

Language: Английский

Citations

0
Apixaban Inhibits Progression of Experimental Diabetic Nephropathy by Blocking Advanced Glycation End Product-Receptor Axis DOI Open Access
Takanori Matsui, Ami Sotokawauchi,

Yuri Nishino

et al.

International Journal of Molecular Sciences, Journal Year: 2025, Volume and Issue: 26(7), P. 3007 - 3007

Published: March 26, 2025

Diabetes is associated with an increased risk of thromboembolism. However, the effects apixaban, a factor Xa inhibitor on diabetic nephropathy, remain unknown. Six-week-old Wistar rats received single 60 mg/kg intraperitoneal injection streptozotocin to produce model type 1 diabetes. Type and non-diabetic control were treated or without apixaban orally for 8 weeks, blood kidneys obtained biochemical, real-time reverse transcription-polymerase chain reaction (RT-PCR) morphological analyses. Although treatment did not affect glycemic lipid parameters, it significantly (p < 0.01) inhibited increases in advanced glycation end products (AGEs), receptor AGEs (RAGE) mRNA protein levels, 8-hydroxy-2'-deoxyguanosine (8-OHdG), NADPH oxidase-driven superoxide generation at 14 weeks old. Compared rats, gene expression levels monocyte chemoattractant protein-1 (MCP-1), vascular cell adhesion molecule-1 (VCAM-1), transforming growth factor-β (TGF-β), connective tissue (CTGF), fibronectin 14-week-old which enhanced renal kidney injury (KIM-1) Mac-3, extracellular matrix accumulation kidneys, elevated urinary excretion KIM-1, all by apixaban. Urine KIM-1 positively correlated (r = 0.690) 8-OHdG 0.793) serum 0.823). Our present findings suggest that could ameliorate streptozotocin-induced partly blocking AGE-RAGE-oxidative stress axis kidneys.

Language: Английский

Citations

0
The cardio‐renal‐metabolic role of the nod‐like receptor protein‐3 and senescence‐associated secretory phenotype in early sodium/glucose cotransporter‐2 inhibitor therapy in people with diabetes who have had a myocardial infarction DOI Creative Commons
Muhammad Usman Shah, Chelsy L. Cliff, Paul E. Squires

et al.

Diabetic Medicine, Journal Year: 2025, Volume and Issue: unknown

Published: April 25, 2025

Abstract Aims Following an acute myocardial infarction (AMI), individuals with type 2 diabetes (T2DM) have a 2‐to‐3 fold increased risk of mortality compared to those without diabetes, and globally cardiorenal complications account for 50% diabetes‐related deaths. The use sodium/glucose cotransporter‐2 inhibitors (SGLT2i) in people T2DM‐AMI is associated decreased inflammatory burden improved outcomes. mechanisms behind this protection are unclear form the basis study. Methods This single centre, prospective study randomisation will utilise plasma monocyte‐derived macrophages from patients T2DM who recently had AMI prescribed Empagliflozin either immediately following cardiac event or at 3 months post‐AMI. Results test hypothesis that provides anti‐inflammatory by suppressing systemic NOD‐like receptor protein‐3 (NLRP3) inflammasome activation pro‐inflammatory senescence‐associated secretory phenotype (SASP), perpetrators sterile (non‐pathogen evoked) inflammation linked poor clinical outcomes patients. also assess benefits early intervention on these parameters. Conclusions Elucidating role SGLT2i enhance understanding how they can be used effectively treat identify novel pathways future intervention. Furthermore, optimal timing when initiate therapy post‐AMI unclear. Correlating level onset T2DM, cardiovascular establish if greater benefit initiated earlier.

Language: Английский

Citations

0
A special issue on from bench to bedside: An integrated and multidisciplinary approach to tackling diabetic kidney disease DOI Open Access
Janaka Karalliedde, Claire E. Hills

Diabetic Medicine, Journal Year: 2024, Volume and Issue: unknown

Published: Dec. 15, 2024

More than 800 million people have chronic kidney disease (CKD) globally and type 2 diabetes accounts for between 30% 50% of cases CKD.1 Diabetic Kidney (DKD) is associated with increased cardiovascular (CVD) morbidity mortality in many countries also the leading cause end stage needing replacement therapy (dialysis or transplantation).2 DKD impacts on length quality life significantly contributes to global healthcare expenditure these human economic costs are likely rise further future.2, 3 Prognosis progression can differ from one individual another, which often a consequence interactions traditional emerging risk factors as well social-demographic factors, such ethnicity socio-economic factors.4 The recent Research UK health inequalities report demonstrated that South Asian Black backgrounds three five times more require dialysis white background.5 This observation may be part linked increasing prevalence currently unknown determinants progression. management requires multifactorial multidisciplinary approach key focus early identification CKD screening then prompt intervention focussing important lifestyle modifications, using evidence-based medical treatments holistic care.3, 6 With advances pillars treatment includes renin angiotensin system inhibition, sodium glucose co-transporter inhibition (SGLT2-inh), non-steroidal mineralocorticoid receptor antagonists glucagon like peptide 1 agonists (GLP-1 RA) parallel CVD factor modification, there an opportunity intervene change risk.7, 8 For DKD, gaps care options limited contrast diabetes, indeed, high burden this cohort underappreciated.9 natural history has evolved over last 40 years, remains significant residual ESKD premature CVD.9, 10 Despite 30 not optimal present late when modifiability progression/risk less feasible. There thus urgent need better methods biomarkers aid stratification ensure those at highest recognized guideline directed therapies initiated promptly morbidity/mortality.8, 11 glycaemic control challenging setting individualized approach. pathophysiology multifaceted encompasses metabolic haemodynamic perturbations lead structural functional disturbances including glomerular hyper-filtration, mesangial expansion interstitial fibrosis, convergence fundamental mechanisms, 'sterile' inflammation age changes, example cell senescence.12, 13 Although precise role development unclear, studies suggest accelerated ageing phenotype, coupled maladaptive immune response, underlies Furthermore, coexistence disease, so called 'cardiorenal syndrome', occurs face multi-organ crosstalk, evidence suggesting systemic vascular robust predictor poor dyslipidaemia. As obesity, syndrome continue rise, major worldwide. A understanding interrelationships crosstalk different organs/systems contributing complications will enhance scientific could facilitate new interventions prevent treat diabetes-related co-morbidities. mechanisms underpin clinical benefits existing therapies, GLPRA SGLT2i, inform how why drug works both within inter-organ cardiovascular-kidney-metabolic other secondary diabetes. special issue diabetic medicine focussed basic translational research, potential therapeutic targets,12-15 changing diabetes,10 scenarios,11 guidelines their implementation day-to-day patient practice.16 We hope readers enjoy reading collection articles apply related learning drive future research help improve outcomes DKD. None. authors declare no conflicts interest.

Language: Английский

Citations

0