Evaluation and approach to treatment of renal artery stenosis in patients with diabetic nephropathy

Silva, José A.

doi:10.1007/s11892-008-0084-0

Cited by 3 publications

(3 citation statements)

References 57 publications

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“…It is well known that RI, PSV, and 3 Journal of Diabetes Research eGFR were intimately linked with renal perfusion [33], and the study has shown a correlation between RI, PSV, and KBs, which also supports the above conclusions. It is well known that the patients with DM are at high risk of developing atherosclerotic renal artery stenosis (RAS) [34]. However, there is lack of consensus on the relationship between the levels of KBs and renal artery.…”

Section: Discussionmentioning

confidence: 99%

The Value of Ketone Bodies in the Evaluation of Kidney Function in Patients with Type 2 Diabetes Mellitus

Zhang

Shen

et al. 2021

Journal of Diabetes Research

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Objectives. Recent studies have shown that the slightly elevated circulating levels of ketone bodies (KBs) played a significant role in the treatment of various diseases. This study is aimed at investigating the association between different levels of KBs and kidney function in patients with type 2 diabetes mellitus (T2DM). Methods. A retrospective study of 955 patients with T2DM (426 women and 529 men) admitted to our hospital from December 2017 to September 2019 was conducted. Patients were divided into different groups in line with the levels of KBs (low-normal group: 0.02-0.04 mmol/L, middle-normal group: 0.05-0.08 mmol/L, high-normal group: 0.09-0.27 mmol/L, and slightly elevated group: >0.27 and <3.0 mmol/L). Results. In the present study, individuals with high-normal levels of KBs had the lowest risk of diabetic kidney disease (DKD) and increased peak systolic velocity (PSV); those with middle-normal levels of KBs had the lowest risk of increased renal arterial resistive index (RI), with a positive correlation between increased α1-microglobulin and KB concentration. In addition, the indicators of glomerulus, renal tubules, and renal arteries were all poor with slightly elevated circulating levels of KBs, and KB concentration lower than 0.09 mmol/L can be applied as the threshold for low risk of renal function damage. Conclusions. In summary, slightly elevated circulating levels of ketone bodies are not of benefit for renal function in patients with type 2 diabetes mellitus.

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Section: Discussionmentioning

confidence: 99%

The Value of Ketone Bodies in the Evaluation of Kidney Function in Patients with Type 2 Diabetes Mellitus

Zhang

Shen

et al. 2021

Journal of Diabetes Research

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“…Renal artery stenosis (RAS) is a common condition in patients suffering from atherosclerosis and fibromuscular dysplasia [1][2][3][4][5][6], with an overall prevalence disease rate of 15.4% [4]. Progression to severe stenosis is well documented and leads to hypertension and kidney damage [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Renin Angiotensin Aldosterone System Functions in Renovascular Hypertension

Gómez¹

2021

Renin-Angiotensin Aldosterone System

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The renin angiotensin aldosterone system (RAAS) plays a key function in renovascular hypertension induced by renal artery stenosis (RAS). RAS causes a decrease in renal perfusion in the stenosed kidney which in turn stimulates renin the rate limiting enzyme in RAAS. This stimulation triggers a series of events starting with renin release leading to Ang II production, decrease in sodium excretion, increase sympathetic tone; all contributing to the development of renovascular hypertension. In RAS increase of superoxide reduce nitric oxide in the afferent arteriole increasing vasoconstriction and a marked decrease in glomerular filtration rate. In renovascular hypertension prostaglandins mediate renin release in the stenosed kidney. Targeting different RAAS components is part of the therapy for renovascular hypertension, with other options including renal nerves denervation and revascularization. Different clinical studies had explored revascularization, RAAS blocking and renal nerves denervation as a therapy. We will discuss organ, cellular and molecular components of this disease.

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“…Long-term hyperglycemia not only significantly impairs the microstructure of the kidney, leading to diabetic nephropathy (DN), but also causes renal artery stenosis (RAS) in diabetic patients [ 1 , 2 ]. The RAS detection rate in type 2 diabetes patients was recently reported to be 36.9% using duplex ultrasound scanning [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Combined Microencapsulated Islet Transplantation and Revascularization of Aortorenal Bypass in a Diabetic Nephropathy Rat Model

Chen

et al. 2016

Journal of Diabetes Research

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Objective. Revascularization of aortorenal bypass is a preferred technique for renal artery stenosis (RAS) in diabetic nephropathy (DN) patients. Restenosis of graft vessels also should be considered in patients lacking good control of blood glucose. In this study, we explored a combined strategy to prevent the recurrence of RAS in the DN rat model. Methods. A model of DN was established by intraperitoneal injection of streptozotocin. Rats were divided into 4 groups: SR group, MIT group, Com group, and the untreated group. The levels of blood glucose and urine protein were measured, and changes in renal pathology were observed. The expression of monocyte chemoattractant protein-1 (MCP-1) in graft vessels was assessed by immunohistochemical staining. Histopathological staining was performed to assess the pathological changes of glomeruli and tubules. Results. The levels of urine protein and the expression of MCP-1 in graft vessels were decreased after islet transplantation. The injury of glomerular basement membrane and podocytes was significantly ameliorated. Conclusions. The combined strategy of revascularization and microencapsulated islet transplantation had multiple protective effects on diabetic nephropathy, including preventing atherosclerosis in the graft vessels and alleviating injury to the glomerular filtration barrier. This combined strategy may be helpful for DN patients with RAS.

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Evaluation and approach to treatment of renal artery stenosis in patients with diabetic nephropathy

Cited by 3 publications

References 57 publications

The Value of Ketone Bodies in the Evaluation of Kidney Function in Patients with Type 2 Diabetes Mellitus

The Value of Ketone Bodies in the Evaluation of Kidney Function in Patients with Type 2 Diabetes Mellitus

Renin Angiotensin Aldosterone System Functions in Renovascular Hypertension

Combined Microencapsulated Islet Transplantation and Revascularization of Aortorenal Bypass in a Diabetic Nephropathy Rat Model

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