CKD in diabetes: diabetic kidney disease versus nondiabetic kidney disease

Nature Reviews Nephrology, Год журнала: 2018, Номер 14(6), С. 361 - 377

Опубликована: Апрель 13, 2018

Язык: Английский

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GLP-1 and the kidney: from physiology to pharmacology and outcomes in diabetes

Nature Reviews Nephrology, Год журнала: 2017, Номер 13(10), С. 605 - 628

Опубликована: Сен. 4, 2017

Язык: Английский

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High-fat diet promotes renal injury by inducing oxidative stress and mitochondrial dysfunction

Cell Death and Disease, Год журнала: 2020, Номер 11(10)

Опубликована: Окт. 24, 2020

Abstract Obesity has been recognized as a major risk factor for chronic kidney disease, but the underlying mechanism remains elusive. Here, we investigated whereby long-term high-fat diet (HFD) feeding induces renal injury in mice. The C57BL/6 mice fed HFD 16 weeks developed obesity, diabetes, and dysfunction manifested by albuminuria blood accumulation of BUN creatinine. HFD-fed showed marked glomerular tubular injuries, including prominent defects filtration barrier increased cell apoptosis. Mechanistically, markedly triglyceride cholesterol contents activated lipogenic pathways synthesis. also oxidative stress induced mitochondrial fission cells, thereby activating pro-apoptotic pathway. In HK-2 mesangial cultures, high glucose, fatty acid, TNF-α combination was able to activate pathways, increase stress, promote fission, pathway, all which could be attenuated an inhibitor that depleted reactive oxygen species. Taken together, these observations suggest causes at least part result tissue lipid accumulation, dysfunction, excess programmed death.

Язык: Английский

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Obesity and heart failure with preserved ejection fraction: new insights and pathophysiological targets

Cardiovascular Research, Год журнала: 2022, Номер 118(18), С. 3434 - 3450

Опубликована: Июль 26, 2022

Abstract Obesity and heart failure with preserved ejection fraction (HFpEF) represent two intermingling epidemics driving perhaps the greatest unmet health problem in cardiovascular medicine 21st century. Many patients HFpEF are either overweight or obese, recent data have shown that increased body fat its attendant metabolic sequelae widespread, protean effects systemically on system leading to symptomatic HFpEF. The paucity of effective therapies underscores importance understanding distinct pathophysiological mechanisms obese develop novel therapies. In this review, we summarize current non-cardiovascular features phenotype HFpEF, how adiposity might pathophysiologically contribute phenotype, these processes be targeted therapeutically.

Язык: Английский

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Nitric oxide signalling in kidney regulation and cardiometabolic health

Nature Reviews Nephrology, Год журнала: 2021, Номер 17(9), С. 575 - 590

Опубликована: Июнь 1, 2021

Язык: Английский

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Obesity-related kidney disease: Beyond hypertension and insulin-resistance

Frontiers in Endocrinology, Год журнала: 2023, Номер 13

Опубликована: Янв. 16, 2023

Chronic kidney disease (CKD) causes considerable morbidity, mortality, and health expenditures worldwide. Obesity is a significant risk factor for CKD development, partially explained by the high prevalence of diabetes mellitus hypertension in obese patients. However, adipocytes also possess potent endocrine functions, secreting myriad cytokines adipokines that contribute to insulin resistance induce chronic low-grade inflammatory state thereby damaging kidney. development itself associated with various metabolic alterations exacerbate adipose tissue dysfunction resistance. This adipose-renal axis major focus current research, given rising incidence obesity. Cellular senescence biologic hallmark aging, age another obesity CKD. An elevated senescent cell burden predicts renal animal models, senotherapies may alleviate these phenotypes. In this review, we discuss direct mechanisms which contributes emphasizing potential clinical importance such pathways augmenting care

Язык: Английский

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Angiopoietin-like protein 8 differentially regulates ANGPTL3 and ANGPTL4 during postprandial partitioning of fatty acids

Journal of Lipid Research, Год журнала: 2020, Номер 61(8), С. 1203 - 1220

Опубликована: Июнь 3, 2020

Angiopoietin-like protein (ANGPTL)8 has been implicated in metabolic syndrome and reported to regulate adipose FA uptake through unknown mechanisms. Here, we studied how complex formation of ANGPTL8 with ANGPTL3 or ANGPTL4 varies feeding LPL. In human serum, ANGPTL3/8 ANGPTL4/8 complexes both increased postprandially, correlated negatively HDL, positively all other markers. also LDL-C blocked LPL-facilitated hepatocyte VLDL-C uptake. LPL-inhibitory activity was >100-fold more potent than that ANGPTL3, less ANGPTL4. Quantitative analyses inhibitory activities competition experiments among the suggested a model which localized blocks circulating ANGPTL4, allowing lipid sequestration into fat rather muscle during fed state. Supporting this model, insulin secretion from hepatocytes adipocytes. These results suggest low levels fasting enable ANGPTL4-mediated LPL inhibition tissue minimize During feeding, increases via ANGPTL3/8, while decreasing ANGPTL4/8, thereby increasing tissue. Excessive caloric intake may shift system toward latter conditions, possibly predisposing syndrome.

Язык: Английский

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Relationships between resilience, empathy, compassion fatigue, work engagement and turnover intention in haemodialysis nurses: A cross‐sectional study

Journal of Nursing Management, Год журнала: 2021, Номер 29(5), С. 1054 - 1063

Опубликована: Янв. 4, 2021

Aim To explore the relationships between resilience, empathy, compassion fatigue, work engagement and turnover intention in Chinese haemodialysis nurses. Background Although several studies explored nurses' multiple hospital wards, fewer focused on its predictors among nurses dialysis care. Methods We conducted a cross-sectional study adopted two-stage sampling method to recruit 528 Multiple regression analysis was performed effects of fatigue intention. Results The prevalence high exceptionally levels 59.1% 9.0%. Compassion had strongest significant effect (β = 0.276), followed by −0.256) resilience 0.193). Haemodialysis tertiary hospitals reported higher than those secondary 0.127). Conclusions Higher lower can result Implications for Nursing Management Strategies such as training programme, mindfulness-based intervention establishing positive environment may be effective methods improve reduce promote decrease

Язык: Английский

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The Triglyceride-Glucose Index and Obesity-Related Risk of End-Stage Kidney Disease in Austrian Adults

JAMA Network Open, Год журнала: 2021, Номер 4(3), С. e212612 - e212612

Опубликована: Март 31, 2021

Importance

It is unknown whether the triglyceride-glucose (TyG) index as a measure of insulin resistance associated with risk developing end-stage kidney disease (ESKD). Because individuals who are overweight or obese often develop resistance, mediation association between body mass (BMI) and ESKD through TyG seems plausible but has not been investigated.

Objective

To evaluate and, if so, to what extent mediates BMI ESKD.

Design, Setting, Participants

A total 176 420 were recruited during routine health examinations participate in Austrian Vorarlberg Health Monitoring Promotion Program (VHM&PP), prospective, population-based cohort study participant enrollment January 1, 1988, June 30, 2005, mean follow-up 22.7 years. Data analysis was conducted from March 2020, September 2020.

Exposures

Body logarithmized product fasting triglyceride glucose concentrations (TyG index), determined baseline examination.

Main Outcomes Measures

End-stage disease, indicated by initiation replacement therapy, either dialysis transplantation.

Results

Of participants, 94 885 women (53.8%); (SD) age 42.5 (15.4) During (6.9) years, 454 (0.3%) participants developed 35 234 (20.0%) died. In multivariable-adjusted Cox proportional hazards models, significantly ESKD, both (hazard ratio [HR] per 1-SD increase, 1.68; 95% CI, 1.56-1.82) without (HR 1.79; 1.66-1.93) inclusion covariate. Mediation using newly proposed 2-stage regression method for survival data showed that 5-point increase increased 58% [total association], 1.58; 1.43-1.75), 41.7% (95% 31.6%-51.8%) mediated [indirect 1.21; 1.18-1.25).

Conclusions Relevance

This found appeared be nearly half general population. Public efforts aiming at reduction weight might decrease sequelae burden

Язык: Английский

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A Nephrologist Perspective on Obesity: From Kidney Injury to Clinical Management

Frontiers in Medicine, Год журнала: 2021, Номер 8

Опубликована: Апрель 13, 2021

Obesity is one of the epidemics our era. Its prevalence higher than 30% in U.S. and it estimated to increase by 50% 2030. associated with a risk all-cause mortality known be cause chronic kidney disease (CKD). Typically, obesity-related glomerulopathy (ORG) ascribed renal hemodynamic changes that lead hyperfiltration, albuminuria and, finally, impairment glomerular filtration rate due glomerulosclerosis. Though not only hemodynamics are responsible for ORG: adipokines could local effects on mesangial tubular cells podocytes promoting maladaptive responses hyperfiltration. Furthermore, hypertension type 2 diabetes mellitus, two conditions generally obesity, both amplifiers obesity injury parenchyma, as well complications overweight. As native kidney, also related worse outcomes transplantation. Despite its impact CKD cardiovascular morbility mortality, therapeutic strategies fight against were limited decades renin-angiotensin blockade bariatric surgery patients who accomplished very restrictive criteria. Last years, different drugs have been approved or under study treatment obesity. Glucagon-like peptide-1 receptor agonists promising since they shown benefits terms losing weight obese patients, preventing onset macroalbuminuria slowing decline eGFR diabetes. These new families glucose-lowering frontier crossed nephrologists stop progression.

Язык: Английский

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