Targeted identification of risk and treatment of diabetic kidney disease

Glastras, Sarah J.; Pollock, Carol A.

doi:10.1038/s41581-023-00796-9

Cited by 3 publications

(1 citation statement)

References 10 publications

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“…The experts were defined as specialists in nephrology, endocrinology/diabetology, internal medicine and primary care medicine who had achieved an appropriate level of seniority within their field (eg, professors, clinical directors), or had published papers related to the management of CKD/HF/Diabetes, or had been involved in guidelines development. [13][14][15][16][17][18][19][20][21] The steering group members were selected to provide representation across a range of development indicator levels external to Europe and North America (to avoid replication of previous published work 22 ). Steering group members were recruited to represent countries outside of North America and Europe.…”

Section: Methodsmentioning

confidence: 99%

Results from a cross-specialty consensus on optimal management of patients with chronic kidney disease (CKD): from screening to complications

Arici,

Assaad-Khalil,

Bertoluci

et al. 2024

BMJ Open

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BackgroundChronic kidney disease (CKD) affects around 10% of the global population and has been estimated to affect around 50% of individuals with type 2 diabetes and 50% of those with heart failure. The guideline-recommended approach is to manage with disease-modifying therapies, but real-world data suggest that prescribing rates do not reflect this in practice.ObjectiveTo develop a cross-specialty consensus on optimal management of the patient with CKD using a modified Delphi method.DesignAn international steering group of experts specialising in internal medicine, endocrinology/diabetology, nephrology and primary care medicine developed 42 statements on aspects of CKD management including identification and screening, risk factors, holistic management, guidelines, cross-specialty alignment and education. Consensus was determined by agreement using an online survey.ParticipantsThe survey was distributed to cardiologists, nephrologists, endocrinologists and primary care physicians across 11 countries.Main outcomes and measuresThe threshold for consensus agreement was established a priori by the steering group at 75%. Stopping criteria were defined as a target of 25 responses from each country (N=275), and a 4-week survey period.Results274 responses were received in December 2022, 25 responses from Argentina, Australia, Brazil, Guatemala, Mexico, Singapore, South Korea, Taiwan, Thailand, Turkey and 24 responses from Egypt. 53 responses were received from cardiologists, 52 from nephrologists, 55 from endocrinologists and 114 from primary care physicians. 37 statements attained very high agreement (≥90%) and 5 attained high agreement (≥75% and <90%). Strong alignment between roles was seen across the statements, and different levels of experience (2–5 years or 5+ years), some variation was observed between countries.ConclusionsThere is a high degree of consensus regarding aspects of CKD management among healthcare professionals from 11 countries. Based on these strong levels of agreement, the steering group derived 12 key recommendations focused on diagnosis and management of CKD.

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Section: Methodsmentioning

confidence: 99%

Results from a cross-specialty consensus on optimal management of patients with chronic kidney disease (CKD): from screening to complications

Arici,

Assaad-Khalil,

Bertoluci

et al. 2024

BMJ Open

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Upregulation of Metrnl improves diabetic kidney disease by inhibiting the TGF-β1/Smads signaling pathway: A potential therapeutic target

Lin,

Huang,

Lin

et al. 2024

PLoS ONE

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Purpose This study comprises an investigation of the role of meteorin-like (Metrnl) in an experimental model of diabetic kidney disease (DKD). Methods Twenty-four db/db mice were randomly assigned to one of the following groups: DKD, DKD + Metrnl-/-, and DKD + Metrnl+/+. Plasma Metrnl concentrations were measured using ELISA. Kidney tissues were examined via western blotting, qRT-PCR, and immunohistochemistry to determine the expression levels of inflammatory factors. Electron microscopy was employed to observe stained kidney sections. Results Compared with the NC group, FBG, BW, and UACR were elevated in the DKD and Metrnl-/- groups, with severe renal pathological injury, decreased serum Metrnl concentration, decreased renal Metrnl expression, and increased expression levels of TNF-α, TGF-β1, TGF-R1, pSmad2, pSmad3, and α-SMA. In contrast, the Metrnl+/+ group showed decreased FBG and UACR, BUN, TC and TG, increased HDL-C and serum Metrnl concentration, increased renal Metrnl expression, and decreased expression of TNF-α, TGF-β1, TGF-R1, pSmad2, pSmad3, and α-SMA, compared to the DKD and Metrnl-/- groups. A Pearson bivariate correlation analysis revealed a negative correlation between UACR and Metrnl, and a positive correlation between UACR and TGF-β1. Conclusion Upregulation of renal Metrnl expression can improve renal injury by downregulating the expression of molecules in the TGF-β1/Smads signaling pathway in the renal tissues of type 2 diabetic mice; and by reducing the production of fibrotic molecules such as α-SMA.

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Podocyte Death in Diabetic Kidney Disease: Potential Molecular Mechanisms and Therapeutic Targets

Zhong,

Wang,

Zhang

2024

IJMS

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Cell deaths maintain the normal function of tissues and organs. In pathological conditions, the abnormal activation or disruption of cell death often leads to pathophysiological effects. Diabetic kidney disease (DKD), a significant microvascular complication of diabetes, is linked to high mortality and morbidity rates, imposing a substantial burden on global healthcare systems and economies. Loss and detachment of podocytes are key pathological changes in the progression of DKD. This review explores the potential mechanisms of apoptosis, necrosis, autophagy, pyroptosis, ferroptosis, cuproptosis, and podoptosis in podocytes, focusing on how different cell death modes contribute to the progression of DKD. It recognizes the limitations of current research and presents the latest basic and clinical research studies targeting podocyte death pathways in DKD. Lastly, it focuses on the future of targeting podocyte cell death to treat DKD, with the intention of inspiring further research and the development of therapeutic strategies.

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Targeted identification of risk and treatment of diabetic kidney disease

Cited by 3 publications

References 10 publications

Results from a cross-specialty consensus on optimal management of patients with chronic kidney disease (CKD): from screening to complications

Results from a cross-specialty consensus on optimal management of patients with chronic kidney disease (CKD): from screening to complications

Upregulation of Metrnl improves diabetic kidney disease by inhibiting the TGF-β1/Smads signaling pathway: A potential therapeutic target

Podocyte Death in Diabetic Kidney Disease: Potential Molecular Mechanisms and Therapeutic Targets

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