Hypertension in Diabetic Nephropathy: Epidemiology, Mechanisms, and Management

Buren, Peter Noel Van; Toto, Robert

doi:10.1053/j.ackd.2010.10.003

Cited by 188 publications

(129 citation statements)

References 94 publications

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“…Considering the high frequency of hypertension and severe proteinuria in our nephropathy patients, and their associations with preterm delivery, it is possible that intensified control of BP levels starting from early pregnancy could improve outcomes [7,16,40]. Aggressive treatment with up to four antihypertensive drugs may be required to reach target levels, due to long-term haemodynamic alterations, such as increased peripheral vasoconstriction [13,16,41]. Baseline assessments of proteinuria and kidney function should be performed before or in early pregnancy in parturients with diabetes to identify those with need for strict antihypertensive control.…”

Section: Discussionmentioning

confidence: 99%

Obstetric and perinatal outcome in type 1 diabetes patients with diabetic nephropathy during 1988–2011

et al. 2015

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Aims/hypothesis Our aim was to analyse possible changes in the glycaemic control, BP, markers of renal function, and obstetric and perinatal outcomes of parturients with diabetic nephropathy during 1988-2011. Methods The most recent childbirth of 108 consecutive type 1 diabetes patients with diabetic nephropathy and a singleton pregnancy were studied. Two periods, 1988Two periods, -1999Two periods, and 2000Two periods, -2011 . Antihypertensive medication usage increased before pregnancy (34% vs 65%, p=0.002) and in the second and third trimesters of pregnancy (25% vs 47%, p=0.02, and 36% vs 60%, p =0.01, respectively). BP exceeded 130/ 80 mmHg in 62% and 61% (p=0.87) of patients in the first trimester, and in 95% and 93% (p=0.69) in the third trimester, respectively. No changes were observed in the markers of renal function. Pre-eclampsia (52% vs 42%, p=0.29) and preterm birth rates before 32 and 37 gestational weeks (14% vs 21%, p=0.33, and 71% vs 77%, p=0.49, respectively) remained high. The elective and emergency Caesarean section rates were 71% and 45% (p=0.01) and 29% and 48% (p= 0.05), respectively. Neonatal intensive care unit admissions increased from 26% to 49% (p=0.02). Conclusions/interpretation Early pregnancy glycaemic control and hypertension management were suboptimal in both time periods. Pre-eclampsia and preterm delivery rates remained high in patients with diabetic nephropathy.

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Section: Discussionmentioning

confidence: 99%

Obstetric and perinatal outcome in type 1 diabetes patients with diabetic nephropathy during 1988–2011

et al. 2015

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“…Although RAS activation may contribute to the progression of diabetic nephropathy, the mechanism of this pathology is incompletely understood (Van Buren & Toto, 2011). Interestingly, ERK1/2 phosphorylation observed in diabetic nephropathy could be explained by succinateactivated SUCNR1 in the renal tubules of diabetic mice (Robben et al, 2009).…”

Section: Diabetes and Obesitymentioning

confidence: 99%

Insight into SUCNR1 (GPR91) structure and function

Gilissen

Jouret

Pirotte

et al. 2016

Pharmacology & Therapeutics

113

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SUCNR1 (or GPR91) belongs to the family of G protein-coupled receptors (GPCR), which represents the largest group of membrane proteins in human genome. The majority of marketed drugs targets GPCRs, directly or indirectly. SUCNR1 has been classified as an orphan receptor until a landmark study paired it with succinate, a citric acid cycle intermediate.According to the current paradigm, succinate triggers SUCNR1 signaling pathways to indicate local stress that may affect cellular metabolism. SUCNR1 implication has been well documented in renin-induced hypertension, ischemia/reperfusion injury, inflammation and immune response, platelet aggregation and retinal angiogenesis. In addition, the SUCNR1-induced increase of blood pressure may contribute to diabetic nephropathy or cardiac hypertrophy.The understanding of SUCNR1 activation, signaling pathways and functions remains largely elusive, which calls for deeper investigations. SUCNR1 shows a high potential as an innovative drug target and is probably an important regulator of basic physiology. In order to achieve the full characterization of this receptor, more specific pharmacological tools such as small-molecules modulators will represent an important asset. In this review, we describe the structural features of SUCNR1, its current ligands and putative binding pocket. We give an exhaustive overview of the known and hypothetical signaling partners of the receptor in different in vitro and in vivo systems. The link between SUCNR1 intracellular pathways and its pathophysiological roles are also extensively discussed.

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“…12 Por outro lado, é consenso que a busca do controle pressórico ultrapassa discussões relativas a diferentes classes de drogas. Dito de outra maneira, não cabe discutir o benefício de determinada classe de droga sem que antes se assegure o controle pressórico rigoroso nos pacientes diabéticos hipertensos.…”

Section: Controle Pressóricounclassified

O acometimento renal na hipertensão arterial e diabetes mellitus tipo 2: como identificar e prevenir – A visão do nefrologista

Júnior

Suassuna

2013

Revista Hospital Universitário Pedro Ernesto

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Hypertension in Diabetic Nephropathy: Epidemiology, Mechanisms, and Management

Cited by 188 publications

References 94 publications

Obstetric and perinatal outcome in type 1 diabetes patients with diabetic nephropathy during 1988–2011

Obstetric and perinatal outcome in type 1 diabetes patients with diabetic nephropathy during 1988–2011

Insight into SUCNR1 (GPR91) structure and function

O acometimento renal na hipertensão arterial e diabetes mellitus tipo 2: como identificar e prevenir – A visão do nefrologista

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