Molecular insights of diabetic nephropathy and chemical constituents-based treatment approach

Phytochemistry Reviews, Год журнала: 2025, Номер unknown

Опубликована: Янв. 27, 2025

Язык: Английский

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The Potential of Blood KIM‐1 as a Biomarker in Early Diagnosis of Diabetic Kidney Disease

iLABMED, Год журнала: 2025, Номер unknown

Опубликована: Фев. 14, 2025

KIM-1 can be upregulated by kidney injury, detectable in the blood during early DKD stages diabetic patients, including those without albuminuria. Therefore, holds value for diagnostic strategies. Diabetic disease (DKD) affects approximately 40% of patients with diabetes globally and is leading cause end-stage (ESKD) [1]. With increasing prevalence recent years, has become a major public health challenge, contributing to significant healthcare burdens. Moreover, compared who have alone, face markedly higher risk cardiovascular significantly increased mortality [2]. This highlights importance diagnosis manage slow progression, prevent severe outcomes, improve overall patient prognosis. develops as persistent high glucose levels damage, inflammation, glomerular hyperfiltration, fibrosis, ultimately resulting nephron loss [3]. The are often asymptomatic, making it challenging detect before damage occurs. As progresses, albumin urine becomes evident, representing one earliest clinical signs disease. A primary indicator albumin-to-creatinine ratio (UACR) An elevated UACR indicates permeability filtration barrier renal injury. However, limitation its inability injury non-albuminuric DKD. Research shown that occur urine, 8%–12% cases caused type 2 mellitus (T2DM) do not present albuminuria [4]. Thus, may fail identify these individuals. Another key estimated rate (eGFR), which calculated using serum creatinine level along age, sex, race estimate kidneys' filtering capacity eGFR typically remains within normal ranges until substantial occurred, potentially delaying treatment earlier, more treatable [5]. based on abnormalities two above-mentioned indicators, while excluding other potential causes chronic disease—a process both complex time-consuming identifying specific applicable biomarkers diverse crucial developing simple accurate detection method improves outcomes. Several indicators been investigated tumor necrosis factor receptor 1 (TNFR1) Some reportedly indicate occurrence DKD, trials demonstrating their independent association development Among them, molecule (KIM-1) shows particular promise. produced released into bloodstream, easy detect. It predict progression [6]. Additionally, broadly across different types either (T1DM) or T2DM. emerged promising biomarker. I transmembrane glycoprotein primarily expressed apical surface proximal tubular epithelial cells kidney. was first reported Ichimura et al. [7] 1998 novel protein following main structure includes immunoglobulin-like variable domain (IgV), highly glycosylated mucin domain, stalk cytoplasmic (Figure 1). Under conditions, expression low. particularly response increases significantly. plays role clearing apoptotic further IgV binds ligands such phosphatidylserine, contains tyrosine kinase phosphorylation sites, regulates downstream cell signaling pathways, anti-inflammatory responses, autophagy, survival. stem N-glycosylation sites susceptible shedding metalloproteinases. allows extracellular portion Consequently, urinary associated acute [8]. Structure KIM-1. domain. IgV, Ig-like domain; KIM-1, molecule-1; PS, phosphatidylserine. Nevertheless, some research suggests (Table One study demonstrated serve an warning sign decline, patients. upregulation providing opportunity timely identification enabling earlier-stage intervention traditional markers. In 2014, Sabbisetti [9] found were T1DM. cohort 124 T1DM albuminuria, correlated advanced Similarly, report Coca [11] 2017, ACCORD cohort, linked decline. included 190 pairs T2DM, each pair consisting early-stage progressed-stage showed progressed had baseline than These findings underscore marker at interventions could ESKD. (1) relevant (2) predicts ESKD processing risk. strongly progressive function decline demonstrate non-albuminuria (3) independently TNFR-1, TNFR-2 processed stage ones. remained TNFR-1 TNFR-2. Further supporting detection, Nowak [10] 2016 among 259 203 microalbuminuric 77 healthy individuals diabetes. results no difference between finding even T1DM—who pose challenge—elevated plasma predicted because subset does develop rendering methods less effective ability universal biomarker addressing critical gap current Beyond predicting progression. Patients likely faster declines over time. 5- 15-year follow-up [9], 63% participants above median (97 pg/mL) ESKD, only 20% below median. predictive capability extends utility beyond diagnosing monitoring informing decisions. studies evaluating multiple biomarkers, consistently few when analyzed collectively. For example, T1DM, irrespective characteristics, TNFR1 levels, markers damage. tubules contribute non-proteinuric [10]. provides distinct valuable insights complement, rather duplicate, information offered biomarkers. incorporating protocols precision Although promise several challenges must addressed widely used practice. First, vary populations non-renal factors systemic inflammation comorbidities elevate reducing specificity. needed assess impact establish population-specific reference values, ensuring measurements clinically meaningful. standardized, reliable, cost-effective detecting broader adoption. should prioritize sensitivity specificity being practical use various settings. diagnosis, critical. enzyme-linked immunosorbent assay chemiluminescent immunoassay limitations speed, low-concentration missed diagnoses [12]. By contrast, nanoparticle-based sensors offer sensitivity, much lower concentrations. accuracy but also simplify testing small size, low cost, efficient materials (e.g., metal nanoparticles, quantum dots). Unlike rely expensive equipment procedures, nanoparticle integrated portable devices, accessibility, resource-limited settings [13]. enhancing costs, nanotechnology solution preventing complications from delayed diagnoses. addition, integrating multi-biomarker panels prognostic accuracy. Combining TNFR1, TNFR, cystatin C provide complementary insights, single-biomarker approaches, atypical [14]. Multi-biomarker comprehensive assessment health, facilitating precise stratification. Finally, dynamic tool warrants investigation. While underexplored. Long-term clarify relationship well how fluctuate therapeutic [9]. Such would robust evidence marker, application challenges, standardized user-friendly methods, investigating changes, pivotal management. advancement enhance accuracy, prognosis assessment, optimize conclusion, offering benefits proteinuric To fully harness KIM-1's utility, future standardizing user-friendly, systems. long-term evaluate Addressing will indispensable management, improving Ningjie Gong: conceptualization (equal), data curation investigation writing–original draft (equal). Qian Wang: project administration visualization Zhaoqing Cong: validation Lezhi Xu: Wenqian Yang: Yang Du: supervision authors nothing report. declare conflicts interest. Data sharing this article new created analyzed.

Язык: Английский

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Antioxidant, Antidiabetic, and Vasorelaxant Effects of Ethanolic Extract from the Seeds of Swietenia humilis

International Journal of Molecular Sciences, Год журнала: 2025, Номер 26(5), С. 2063 - 2063

Опубликована: Фев. 27, 2025

Arterial hypertension and diabetes mellitus are components of the cardiometabolic syndrome that arises from a sedentary lifestyle, excess calorie intake, obesity. Swietenia humilis Zucc has been used in traditional Mexican medicine for treatment mellitus; this work investigated antioxidant, antidiabetic, vasorelaxant effects ethanolic extract S. seeds. The phytochemical composition was analyzed by high-performance liquid chromatography. To study hypoglycemic effect, activity antioxidant enzymes (catalase, superoxide dismutase, glutathione peroxidase) markers oxidative stress (malondialdehyde 8-hydroxy-2-desoxyguanosine) were evaluated model induced nicotinamide streptozotocin rats. vasodilatory effect tested rat aortic rings. seeds showed hypoglycemic, endothelium-independent effects, probably blocking calcium transport, likely due to ursolic acid α-amyrin, compounds more abundant extract.

Язык: Английский

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Associations between kidney function with all-cause and cause-specific mortality in type 2 diabetes mellitus patients: a prospective cohort study in China

Journal of Health Population and Nutrition, Год журнала: 2025, Номер 44(1)

Опубликована: Март 13, 2025

Abnormal kidney function is associated with adverse outcomes in patients type 2 diabetes mellitus (T2DM). However, the evidence between and mortality among Chinese T2DM were still limited. This cohort study included 19,919 participants baseline from 2013 to 2014 Jiangsu, China. Serum estimated glomerular filtration rate (eGFR), urea, uric acid measured at baseline, Cox regression models used evaluate hazard ratios (HRs) 95% confidential intervals (95%CIs) of all-cause cause-specific mortality. Restricted cubic splines analyze dose-response relationships, we explored best cut-off values by receiver operating characteristic (ROC) curves. During a median follow-up 9.77 years, 4,428 deaths occurred, including 1,542 (34.8%) due cardiovascular disease (CVD), 1,074 (24.3%) cancer. Compared lowest quintile level (Q1), highest (Q5) eGFR was negatively (HR = 0.67, 95%CI: 0.58–0.77) CVD 0.57, 95%CI 0.44–0.75). The higher levels urea positively (Q5 vs. Q1: HR 1.27, 1.16–1.39; 1.21, 1.10–1.34), an overall "U-shaped" relationships. Moreover, cancer 0.79, 0.66–0.95). 88.50 ml/min/1.73m2, 6.95 mmol/L 342.50 µmol/L for eGFR, acid, respectively. We found abnormal people T2DM. More clinical researches are needed validate effects on risk prevention management.

Язык: Английский

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Exploring the Impact of Diabetes on Kidney Transplant: Patient Outcomes and Management Strategies

Cureus, Год журнала: 2025, Номер unknown

Опубликована: Март 19, 2025

Diabetic kidney disease (DKD) is a serious consequence of diabetes mellitus (DM). If not managed effectively, DKD often develops into end-stage renal (ESRD). The most successful treatment for ESRD transplantation, offering improved quality life and survival rates. For insulin-dependent diabetic patients with ESRD, simultaneous pancreas-kidney transplantation (SPKT) offers alternative that treats both failure the underlying diabetes. However, SPKT involves more complicated surgery, prolonged operative time, higher risk complications. This review aims to highlight impact DM on transplant recipients (KTRs) regarding post-transplant complications, graft survival, mortality rates, role glucose-lowering medications immunosuppressants. incidence urinary tract infections, cardiovascular foot was among KTRs. A decrease in rate at five years observed diabetics compared non-diabetics, similar rates type 1 2 DM. notably patients, complications being leading cause. emergence new-onset post-transplantation (NODAT) significant cause concern. Certain factors, including family history DM, age >45 years, obesity, male gender, immunosuppressive medications, have been linked this phenomenon. Immunosuppression substantial challenge as certain such tacrolimus shown be considerably diabetogenic cyclosporine belatacept, it also postulated corticosteroids can lead hyperglycemia. Some studies proved insulin degludec, glucagon-like peptide-1 receptor agonists, thiazolidinediones, sodium-glucose cotransporter inhibitors, are safe effective these debatable low confidence. Hence, imperative conduct large clinical trials establish definitive guidelines manage pre-existing NODAT KTRs multidisciplinary care help clinicians improve patient outcomes.

Язык: Английский

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Hypoglycemic and Lipid Metabolic Control in Streptozotocin-Induced Diabetic Mice by Hybrid Extract

Food Bioscience, Год журнала: 2025, Номер unknown, С. 106499 - 106499

Опубликована: Апрель 1, 2025

Язык: Английский

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The application value of multimodal ultrasound imaging technology in the prediction of early-stage type 2 diabetic kidney disease

Scientific Reports, Год журнала: 2025, Номер 15(1)

Опубликована: Апрель 11, 2025

Diabetic kidney disease (DKD) is the primary cause of end-stage renal disease. This study examines diagnostic efficacy multi-modal ultrasound imaging technology for early detection DKD, offering a valuable reference prompt diagnosis affected patients. The clinical data 88 patients with early-stage type 2 diabetic (E-T2DKD group), 82 uncomplicated diabetes (T2DM and healthy individuals (control group) who underwent physical examinations at outpatient clinic Affiliated Jiangning Hospital Nanjing Medical University, were analyzed. Multimodal (MUIT) was employed to detect various parameter indicators, prediction model developed using receiver operating characteristic (ROC) curve. results indicated no significant differences in age, gender, BMI among three patient groups. In comparison T2DM group, those E-T2DKD group exhibited significantly higher durations HbA1C levels. Significant observed function-related indicators assessed across groups, including Cystatin C, β2-microglobulin (β2-MG), serum retinol-binding protein (S-RBP), creatinine (Scr), plasma urea nitrogen (PUN), estimated glomerular filtration rate (eGFR), urine neutrophil gelatinase-associated lipocalin (U-NGAL), (U-RBP), N-acetyl-β-D-glucosaminidase (U-NAG) urinary albumin excretion rates (UAER) (p < 0.05), whereas found eGFR, Scr PUN levels between control group. Notable statistical groups also identified MUIT parameters, cortex shear wave elastography (SWE), volume index (KVI), interlobar artery (IA) Vsmax, IA Vdmin, resistance (RI), pulsatility (PI) 0.05). SWE, KVI, RI, PI than both while RCT/RMT, Vdmin lower These incorporated into binary logistic regression model, joint predictive value fitted based on coefficients. Further ROC analysis revealed that area under curve (AUC) characteristics reached 0.993, indicating high E-T2DKD.

Язык: Английский

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Association of atherogenic index of plasma with kidney dysfunction in diabetic individuals: findings from two national population-based studies

BMC Endocrine Disorders, Год журнала: 2025, Номер 25(1)

Опубликована: Апрель 18, 2025

Extensive evidence suggests that dyslipidemia is associated with endothelial dysfunction, oxidative stress, and inflammation, all of which can contribute to kidney dysfunction. The atherogenic index plasma (AIP) a novel marker lipid metabolism disorder, but its role in dysfunction diabetic individuals remains controversial. This study aims clarify the association AIP individuals. cross-sectional analyzed representative sample participants aged 20 years older from United States (n = 2,386, NHANES 2007-2018) Korea 698, KNHANES 2012). Weighted multivariate logistic regression analyses smoothed curve fitting were conducted investigate relationship between logarithmically transformed (lgAIP) multiple including albuminuria low estimated glomerular filtration rate (eGFR) Additionally, we interaction subgroup assess whether this remained consistent across different populations. We utilized receiver operating characteristic (ROC) curves compare diagnostic performance other indices for In both databases, higher lgAIP was significantly occurrence (NHANES: OR 7.69, 95%CI: 2.90-20.40; KNHANES: 6.00, 1.05-34.36) fully adjusted model. However, (95% CI) low-eGFR 1.22 (0.33, 4.53) database 2.50 (0.16, 38.62) database, indicating no statistically significant association. Subgroup analysis revealed influenced by age BMI stratification (p < 0.05). Compared indicators, appears be more precise discriminatory predicting Our findings highlight strong Future research should explore mechanisms underlying relationship. Not applicable.

Язык: Английский

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Nephroprotective Effects of Tanacetum balsamita Extract on Metabolic-Induced Renal Injury (MIRI) in Rats

Current Issues in Molecular Biology, Год журнала: 2025, Номер 47(4), С. 293 - 293

Опубликована: Апрель 21, 2025

The progression of type 2 diabetes is associated with multiple complications, one which diabetic nephropathy (DN). This study aimed at investigating the nephroprotective potential two doses 150 mg/kg and 300 Tanacetum balsamita leaf extract (ETB) on metabolic-induced renal injury (MIRI) in rats. Markers oxidative stress antioxidant defense, histopathology, serum biochemistry, urinalysis were measured. Blood glucose level arterial blood pressure assessed weekly for experimental period eight weeks. ETB a high dose significantly decreased levels mildly lowered systolic In kidney, restored marker malondialdehyde, reduced glutathione, markedly increased enzymatic activity related to GSH turnover by 46% (GPx), 22% (GR), 32% (GST), 96% (SOD). elevated urea creatinine alleviated proteinuria along other parameters. Histopathological examination kidney supported observed protective effects. Both ameliorated most investigated parameters similarly positive controls enalapril acarbose. benefits MIRI-induced damages could be mono- dicaffeoylquinic acids together series methoxylated flavones flavonols, may hold significance its antidiabetic activity.

Язык: Английский

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Dapagliflozin has protective effects on palmitate-induced renal tubular epithelial cells by enhancing mitochondrial function and reducing oxidative stress

Journal of Diabetes and its Complications, Год журнала: 2024, Номер 39(2), С. 108930 - 108930

Опубликована: Дек. 9, 2024

Язык: Английский

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