期刊
FRONTIERS IN ENDOCRINOLOGY
卷 13, 期 -, 页码 -出版社
FRONTIERS MEDIA SA
DOI: 10.3389/fendo.2022.872918
关键词
diabetic kidney disease; glomerular hyperfiltration; sodium-glucose cotransporter; tubuloglomerular feedback; renal hemodynamics
资金
- National Natural Science Foundation of China [81970583, 82060138]
- Nature Science Foundation of Jiangxi Province [20202BABL206025]
- Projects in the Second Affiliated Hospital of Nanchang University [2019YNLZ12008]
This paper summarizes the mechanisms of hyperfiltration in early diabetic kidney disease (DKD), including the effect of glucose reabsorption, renal growth, nitric oxide, adenosine, atrial natriuretic peptide, cyclooxygenase, renin-angiotensin-aldosterone system, and endothelin. Potential treatments targeting these mechanisms may provide new therapeutic opportunities for reducing renal burden in DKD patients.
In the existing stages of diabetic kidney disease (DKD), the first stage of DKD is called the preclinical stage, characterized by glomerular hyperfiltration, an abnormally elevated glomerular filtration rate. Glomerular hyperfiltration is an independent risk factor for accelerated deterioration of renal function and progression of nephropathy, which is associated with a high risk for metabolic and cardiovascular disease. It is imperative to understand hyperfiltration and identify potential treatments to delay DKD progress. This paper summarizes the current mechanisms of hyperfiltration in early DKD. We pay close attention to the effect of glucose reabsorption mediated by sodium-glucose cotransporters and renal growth on hyperfiltration in DKD patients, as well as the mechanisms of nitric oxide and adenosine actions on renal afferent arterioles via tubuloglomerular feedback. Furthermore, we also focus on the contribution of the atrial natriuretic peptide, cyclooxygenase, renin-angiotensin-aldosterone system, and endothelin on hyperfiltration. Proposing potential treatments based on these mechanisms may offer new therapeutic opportunities to reduce the renal burden in this population.
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