Blood pressure disturbance in diabetes mellitus

Zanella, M T; Freire, Maria-Beatriz S.; Milagres, Rosangela; Ferreira, Sandra; Bonomo, Pedro-Paulo; Kohlmann, Osvaldo; Ribeiro, Artur Beltrame

doi:10.1097/00004872-199212000-00007

Cited by 5 publications

(1 citation statement)

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“…Their proximal action may also help to explain why SGLT2 inhibitors lead to plasma volume contraction and haemoconcentration, but with an improvement in renal function . In contrast, when given to nonedematous patients, conventional loop diuretics produce little long‐term change in plasma volume or haematocrit, and often cause azotaemia, and they do not ameliorate glomerular hyperfiltration or exert disproportionate effects on albuminuria …”

Section: Effect Of Drugs Used In Diabetes On the Sodium‐hydrogen Exchmentioning

confidence: 99%

Role of the sodium‐hydrogen exchanger in mediating the renal effects of drugs commonly used in the treatment of type 2 diabetes

Packer

2018

Diabetes Obesity Metabolism

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Diabetes is characterized by increased activity of the sodium-hydrogen exchanger (NHE) in the glomerulus and renal tubules, which contributes importantly to the development of nephropathy. Despite the established role played by the exchanger in experimental studies, it has not been specifically targeted by those seeking to develop novel pharmacological treatments for diabetes. This review demonstrates that many existing drugs that are commonly prescribed to patients with diabetes act on the NHE1 and NHE3 isoforms in the kidney. This action may explain their effects on sodium excretion, albuminuria and the progressive decline of glomerular function in clinical trials; these responses cannot be readily explained by the influence of these drugs on blood glucose. Agents that may affect the kidney in diabetes by virtue of an action on NHE include: (1) insulin and insulin sensitizers; (2) incretin-based agents; (3) sodium-glucose cotransporter 2 inhibitors; (4) antagonists of the renin-angiotensin system (angiotensin converting-enzyme inhibitors, angiotensin receptor blockers and angiotensin receptor neprilysin inhibitors); and (5) inhibitors of aldosterone action and cholesterol synthesis (spironolactone, amiloride and statins). The renal effects of each of these drug classes in patients with type 2 diabetes may be related to a single shared biological mechanism.

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Section: Effect Of Drugs Used In Diabetes On the Sodium‐hydrogen Exchmentioning

confidence: 99%