Defective Nitric Oxide Production and Functional Renal Reserve in Patients with Type 2 Diabetes Who Have Microalbuminuria of African and Asian Compared with White Origin

Earle, Kenneth; Mehrotra, Seema; Dalton, R. Neil; Denver, E.; Swaminathan, R.

doi:10.1681/asn.v12102125

Cited by 36 publications

(11 citation statements)

References 35 publications

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“…The higher prevalence of salt‐sensitive hypertension in this population may also be a factor by producing alterations in intrarenal hemodynamics (increased glomerular pressure, increased filtration fraction, and microalbuminuria) after salt loading 30 . African Americans with diabetes also seem to have a lower functional renal reserve than whites 41 . The differences seem to be related to a defect in the production or bioavailability of nitric oxide 41 .…”

Section: Renal Diseasementioning

confidence: 97%

“…41 The differences seem to be related to a defect in the production or bioavailability of nitric oxide. 41 Other postulated reasons include inadequate control of hypertension and the lack of use of renoprotective antihypertensive agents such as angiotensin-converting enzyme inhibitors. 37 Another possible cause relates to the excess obesity in African Americans, particularly in women, given the well-described deleterious effects of obesity on kidney function.…”

Section: Renal Diseasementioning

confidence: 99%

“…30 African Americans with diabetes also seem to have a lower functional renal reserve than whites. 41 The differences seem to be related to a defect in the production or bioavailability of nitric oxide. 41 Other postulated reasons include inadequate control of hypertension and the lack of use of renoprotective antihypertensive agents such as angiotensin-converting enzyme inhibitors.…”

Section: Renal Diseasementioning

confidence: 99%

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Epidemiology of Hypertension and Cardiovascular Disease in African Americans

Flack

Ferdinand

Nasser

2003

J of Clinical Hypertension

107

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Hypertension is a major cause of cardiovascular-renal morbidity and mortality and all-cause mortality. It is a highly significant problem for African Americans; about 30% of all deaths in this population are attributable to hypertension. Compared with whites, hypertension in African Americans is more prevalent, occurs earlier in life, is more severe, and is more often associated with target organ injury such as left ventricular hypertrophy and other cardiovascular complications. Only 25% of all African Americans with hypertension and fewer than 50% of those receiving drug treatment attain a blood pressure <140/90 mm Hg. These control rates are somewhat less than in white Americans. Enhanced awareness and understanding of the epidemiologic patterns of hypertension, other cardiovascular risk factors, risk-factor control rates, and factors influencing these control rates should lead to better approaches to risk-factor control. This most likely would result in a reduction of cardiovascular disease complications.

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Section: Renal Diseasementioning

confidence: 97%

Section: Renal Diseasementioning

confidence: 99%

Section: Renal Diseasementioning

confidence: 99%

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Epidemiology of Hypertension and Cardiovascular Disease in African Americans

Flack

Ferdinand

Nasser

2003

J of Clinical Hypertension

107

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“…As hyperfiltration regresses, RFR is restored, while it again diminishes in advanced stages of DN with macroalbuminuria, as remnant nephrons are maximally hyperfiltrating [ 55 ]. In patients with T2D and microalbuminuria, loss of RFR was more pronounced among individuals of African or Asian origin, and that has been linked to defective NO production or bioavailability [ 56 ]. RFR was also found to be inversely associated with markers of inflammation and with the activity of von Willebrand factor, suggesting a role for endothelial dysfunction [ 57 ].…”

Section: Pathophysiologymentioning

confidence: 99%

Diabetic Proteinuria Revisited: Updated Physiologic Perspectives

Heyman

Dwyer

Sibony

et al. 2022

Cells

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Albuminuria, a hallmark of diabetic nephropathy, reflects not only injury and dysfunction of the filtration apparatus, but is also affected by altered glomerular hemodynamics and hyperfiltration, as well as by the inability of renal tubular cells to fully retrieve filtered albumin. Albuminuria further plays a role in the progression of diabetic nephropathy, and the suppression of glomerular albumin leak is a key factor in its prevention. Although microalbuminuria is a classic manifestation of diabetic nephropathy, often progressing to macroalbuminuria or overt proteinuria over time, it does not always precede renal function loss in diabetes. The various components leading to diabetic albuminuria and their associations are herein reviewed, and the physiologic rationale and efficacy of therapeutic interventions that reduce glomerular hyperfiltration and proteinuria are discussed. With these perspectives, we propose that these measures should be initiated early, before microalbuminuria develops, as substantial renal injury may already be present in the absence of proteinuria. We further advocate that the inhibition of the renin–angiotensin axis or of sodium–glucose co-transport likely permits the administration of a normal recommended or even high-protein diet, highly desirable for sarcopenic diabetic patients.

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“…Patients at risk for PC-AKI have some risk factors (advanced age, diabetes, renal insufficiency, anemia, cardiovascular disease) that result in reduced renal vasodilatory capacity (reduced functional renal reserve), associated with endothelial dysfunction and atherosclerosis [18][19][20].…”

Section: Definitions and Terminologymentioning

confidence: 99%

SIRM-SIN-AIOM: appropriateness criteria for evaluation and prevention of renal damage in the patient undergoing contrast medium examinations—consensus statements from Italian College of Radiology (SIRM), Italian College of Nephrology (SIN) and Italian Association of Medical Oncology (AIOM)

et al. 2022

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The increasing number of examinations and interventional radiological procedures that require the administration of contrast medium (CM) in patients at risk for advanced age and/or comorbidities highlights the problem of CM-induced renal toxicity. A multidisciplinary group consisting of specialists of different disciplines—radiologists, nephrologists and oncologists, members of the respective Italian Scientific Societies—agreed to draw up this position paper, to assist clinicians increasingly facing the challenges posed by CM-related renal dysfunction in their daily clinical practice.The major risk factor for acute renal failure following CM administration (post-CM AKI) is the preexistence of renal failure, particularly when associated with diabetes, heart failure or cancer.In accordance with the recent guidelines ESUR, the present document reaffirms the importance of renal risk assessment through the evaluation of the renal function (eGFR) measured on serum creatinine and defines the renal risk cutoff when the eGFR is < 30 ml/min/1.73 m2 for procedures with intravenous (i.v.) or intra-arterial (i.a.) administration of CM with renal contact at the second passage (i.e., after CM dilution with the passage into the pulmonary circulation).The cutoff of renal risk is considered an eGFR < 45 ml/min/1.73 m2 in patients undergoing i.a. administration with first-pass renal contact (CM injected directly into the renal arteries or in the arterial district upstream of the renal circulation) or in particularly unstable patients such as those admitted to the ICU.Intravenous hydration using either saline or Na bicarbonate solution before and after CM administration represents the most effective preventive measure in patients at risk of post-CM AKI. In the case of urgency, the infusion of 1.4% sodium bicarbonate pre- and post-CM may be more appropriate than the administration of saline.In cancer patients undergoing computed tomography, pre- and post-CM hydration should be performed when the eGFR is < 30 ml/min/1.73 m2 and it is also advisable to maintain a 5 to 7 days interval with respect to the administration of cisplatin and to wait 14 days before administering zoledronic acid.In patients with more severe renal risk (i.e., with eGFR < 20 ml/min/1.73 m2), particularly if undergoing cardiological interventional procedures, the prevention of post-CM AKI should be implemented through an internal protocol shared between the specialists who treat the patient.In magnetic resonance imaging (MRI) using gadolinium CM, there is a lower risk of AKI than with iodinated CM, particularly if doses < 0.1 mmol/kg body weight are used and in patients with eGFR > 30 ml/min/1.73 m2. Dialysis after MRI is indicated only in patients already undergoing chronic dialysis treatment to reduce the potential risk of systemic nephrogenic fibrosis.

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Defective Nitric Oxide Production and Functional Renal Reserve in Patients with Type 2 Diabetes Who Have Microalbuminuria of African and Asian Compared with White Origin

Cited by 36 publications

References 35 publications

Epidemiology of Hypertension and Cardiovascular Disease in African Americans

Epidemiology of Hypertension and Cardiovascular Disease in African Americans

Diabetic Proteinuria Revisited: Updated Physiologic Perspectives

SIRM-SIN-AIOM: appropriateness criteria for evaluation and prevention of renal damage in the patient undergoing contrast medium examinations—consensus statements from Italian College of Radiology (SIRM), Italian College of Nephrology (SIN) and Italian Association of Medical Oncology (AIOM)

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