The Role of Platelets in Diabetic Kidney Disease

Abstract

Diabetic kidney disease (DKD) is among the most common microvascular complications in patients with diabetes, and it currently accounts for the majority of end-stage kidney disease cases worldwide. The pathogenesis of DKD is complex and multifactorial, including systemic and intra-renal inflammatory and coagulation processes. Activated platelets play a pivotal role in inflammation, coagulation, and fibrosis. Mounting evidence shows that platelets play a role in the pathogenesis and progression of DKD. The potentially beneficial effects of antiplatelet agents in preventing progression of DKD has been studied in animal models and clinical trials. This review summarizes the current knowledge on the role of platelets in DKD, including the potential therapeutic effects of antiplatelet therapies.

Development of Serum Lactate Level-Based Nomograms for Predicting Diabetic Kidney Disease in Type 2 Diabetes Mellitus Patients

“… 41 Platelet activation, characterized by pro-inflammatory factor secretion, platelet–leukocyte interaction, and pro-fibrotic responses, was thought to exacerbate renal function decline. 42 Conversely, interventions like intensive glucose control, SUA levels reduction, and antiplatelet therapy have demonstrated efficacy in improving renal function, reducing UACR, and slowing DKD progression. 42–44 Collectively, these findings underscore the critical role of managing hyperglycemia, SUA levels, and platelet activity in both DKD prevention and treatment strategies.…”

“…42 Conversely, interventions like intensive glucose control, SUA levels reduction, and antiplatelet therapy have demonstrated efficacy in improving renal function, reducing UACR, and slowing DKD progression. [42][43][44] Collectively, these findings underscore the critical role of managing hyperglycemia, SUA levels, and platelet activity in both DKD prevention and treatment strategies.…”

CRP/HDL–C and Monocyte/HDL-C ratios as Predictors of Metabolic Syndrome in Patients With Type 2 Diabetes Mellitus

“…High glucose increases CD40L (belonging to the TNF receptor family and structurally similar to the TNF Alpha) and thrombospondin-1 in the platelets. As a result of platelet hyperactivity, platelet microvesicles form concomitant with the formation of endothelial cell microvesicles as one of the critical steps toward the hypercoagulable state ( 40 ).…”

Exploring the potential mechanisms of Tongmai Jiangtang capsules in treating diabetic nephropathy through multi-dimensional data

“…Denudatin B, a natural platelet antagonist, relaxes smooth muscle by inhibiting calcium ions (Ca 2+ ) inward flow and increases the action of cyclic adenosine monophosphate (cAMP) to relax blood vessels. Platelets play a role in inflammation, coagulation, and fibrosis in the pathogenesis of DN, thus platelet antagonists have therapeutic effects on DN (40,41). Hirudinoidine A, an ingredient extracted from leeches, has shown efficacy in the treatment of diabetic nephropathy by modulating inflammatory factors through lyophilized leech powder containing this ingredient (36).…”