Journal
MOLECULAR AND CELLULAR ENDOCRINOLOGY
Volume 378, Issue 1-2, Pages 53-58Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.mce.2013.02.005
Keywords
Cardiorenal metabolic syndrome; Chronic kidney disease; Obesity; Insulin resistance; Hyperinsulinemia; Glomerulus
Categories
Funding
- Dialysis Clinics, Inc.
- NIH [AG040638]
- Veterans Affairs [CDA-2 BB47]
- ASN-ASP Junior Development Grant in Geriatric Nephrology
- T. Franklin Williams Scholarship Award
- Atlantic Philanthropies, Inc.
- John A. Hartford Foundation
- Association of Specialty Professors
- American Society of Nephrology
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The presence of insulin resistance is increasingly recognized as an important contributor to early stage kidney disease independent of the contribution of diabetes. Important in this relationship is the strong correlation between hyperinsulinemia and low levels of albuminuria (e.g. microalbuminuria). Recent work highlight mechanisms for glomerular/tubulointerstitial injury with excess insulin and emerging evidence identifies a unique role for insulin metabolic signaling and altered handling of salt reabsorption at the level of the proximal tubule. Evidence is also emerging for the role of insulin signaling in the glomerulus both epithelial and endothelial. Central to the mechanism of injury is inappropriate activation of the RAAS. (C) 2013 Elsevier Ireland Ltd. All rights reserved.
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