Mechanisms of Diabetic Nephropathy Not Mediated by Hyperglycemia

Diabetes mellitus (DM) is characterized by the appearance of progressive kidney damage, which may progress to end-stage kidney disease. The control of hyperglycemia is usually not sufficient to halt this progression. The kidney damage is quantitatively and qualitatively different in the two forms of diabetes; the typical nodular fibrosis (Kimmelstiel Wilson nodules) appears mostly in type 1 DM, whereas glomerulomegaly is primarily present in type 2 obese DM. An analysis of the different metabolites and hormones in type 1 and type 2 DM and their differential pharmacological treatments might be helpful to advance the hypotheses on the different histopathological patterns of the kidneys and their responses to sodium/glucose transporter type 2 inhibitors (SGLT2i).

Automated summary

Diabetes mellitus causes kidney damage progressing to end-stage kidney disease. The two forms of diabetes have different patterns of kidney damage, necessitating analysis of metabolites and hormones, as well as studying differential pharmacological treatments, to understand histopathological patterns of the kidneys and their responses to SGLT2 inhibitors.