Glucose and Blood Pressure-Dependent Pathways-The Progression of Diabetic Kidney Disease

The major clinical associations with the progression of diabetic kidney disease (DKD) are glycemic control and systemic hypertension. Recent studies have continued to emphasize vasoactive hormone pathways including aldosterone and endothelin which suggest a key role for vasoconstrictor pathways in p...

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Bibliographic Details
Published in:International journal of molecular sciences 2020-03, Vol.21 (6), p.2218
Main Authors: Patel, Devang M, Bose, Madhura, Cooper, Mark E
Format: Article
Language:English
Subjects:
Aldosterone
Animals
Biomarkers
Blood Glucose
Blood Pressure
Cytokines
Diabetes
Diabetes mellitus
Diabetic Nephropathies - etiology
Diabetic Nephropathies - metabolism
Diabetic Nephropathies - pathology
Diabetic Nephropathies - physiopathology
Diabetic nephropathy
Disease control
Disease Progression
Endothelins
Enzymes
Fibrosis
Gene expression
Glucose
Glucose - metabolism
Hemodynamics
Humans
Hyperglycemia
Hypertension
Insulin
Intermediates
Kidney diseases
Kinases
Metabolic Networks and Pathways
Metabolic pathways
Mitochondria - drug effects
Mitochondria - metabolism
Molecular interactions
Oxidative Stress - drug effects
Permeability
Pressure dependence
Protective Agents - pharmacology
Proteins
Pyruvaldehyde
Reactive oxygen species
Renin-Angiotensin System - drug effects
Review
Signal Transduction
Vasoactive agents
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Summary:The major clinical associations with the progression of diabetic kidney disease (DKD) are glycemic control and systemic hypertension. Recent studies have continued to emphasize vasoactive hormone pathways including aldosterone and endothelin which suggest a key role for vasoconstrictor pathways in promoting renal damage in diabetes. The role of glucose per se remains difficult to define in DKD but appears to involve key intermediates including reactive oxygen species (ROS) and dicarbonyls such as methylglyoxal which activate intracellular pathways to promote fibrosis and inflammation in the kidney. Recent studies have identified a novel molecular interaction between hemodynamic and metabolic pathways which could lead to new treatments for DKD. This should lead to a further improvement in the outlook of DKD building on positive results from RAAS blockade and more recently newer classes of glucose-lowering agents such as SGLT2 inhibitors and GLP1 receptor agonists.
ISSN:1422-0067
1661-6596
1422-0067
DOI:10.3390/ijms21062218