The present status and challenges of diabetic nephropathy

doi:10.3877/cma.j.issn.2095-3216.2019.02.001

Abstract

Abstract:

Diabetic nephropathy (DN) is a serious complication of diabetes mellitus. Recently, the incidence of DN has been on the rise, and it has become the main cause of end-stage renal disease (ESRD)in developed countries and also the main cause of ESRD in middle-aged and elderly people in China. It is of great importance to improve the understanding and management of DN. This article was aimed to review the new findings of epidemiology, clinical and pathological diagnosis, susceptibility genes, biomarkers, and treatment of DN in recent years, and gave some new understandings about the present treatment status and challenges of DN to attract the attention of the peers.

Key words: Diabetes mellitus, Diabetic nephropathy, Diagnosis, Treatment

Lin Sun, Hao Zhao. The present status and challenges of diabetic nephropathy[J]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2019, 08(02): 49-54.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhsbyjdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-3216.2019.02.001

https://zhsbyjdzzz.cma-cmc.com.cn/EN/Y2019/V08/I02/49

References 65

[1]	Zhang L, Long J, Jiang W, et al. Trends in chronic kidney disease in China [J]. N Engl J Med, 2016, 375(9):905-906.
[2]	Cho NH, Shaw JE, Karuranga S, et al. IDF diabetes atlas: global estimates of diabetes prevalence for 2017 and projections for 2045 [J]. Diabetes Res Clin Pract, 2018, 138:271-281.
[3]	Wang L, Gao P, Zhang M, et al. Prevalence and ethnic pattern of diabetes and prediabetes in China in 2013 [J]. JAMA, 2017, 317(24):2515-2523.
[4]	Gregg EW, Li Y, Wang J, et al. Changes in diabetes-related complications in the United States, 1990-2010 [J]. N Engl J Med, 2014, 370(16):1514-1523.
[5]	Andrassy KM. Comments on 'KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease’[J]. Kidney Int, 2013, 84(3):622-623.
[6]	Chen C, Wang C, Hu C, et al. Normoalbuminuric diabetic kidney disease [J]. Front Med, 2017, 11(3):310-318.
[7]	Hou JH, Zhu HX, Zhou ML, et al. Changes in the spectrum of kidney diseases: an analysis of 40，759 biopsy-proven cases from 2003 to 2014 in China [J]. Kidney Dis (Basel), 2018, 4(1):10-19.
[8]	Kanwar YS, Sun L, Xie P, et al. A glimpse of various pathogenetic mechanisms of diabetic nephropathy [J]. Annu Rev Pathol, 2011, 6:395-423.
[9]	Tervaert TW, Mooyaart AL, Amann K, et al. Pathologic classification of diabetic nephropathy [J]. J Am Soc Nephrol, 2010, 21(4):556-563.
[10]	Yasuda F, Mii A, Morita M, et al. Importance of frequency and morphological characteristics of nodular diabetic glomerulosclerosis in diabetic nephropathy [J]. Hum Pathol, 2018, 75:95-103.
[11]	Hoshino J, Furuichi K, Yamanouchi M, et al. A new pathological scoring system by the Japanese classification to predict renal outcome in diabetic nephropathy [J]. PLoS One, 2018, 13(2):e190923.
[12]	Furuichi K, Yuzawa Y, Shimizu M, et al. Nationwide multicentre kidney biopsy study of Japanese patients with type 2 diabetes [J]. Nephrol Dial Transplant, 2018, 33(1):138-148.
[13]	Zhu X, Xiong X, Yuan S, et al. Validation of the interstitial fibrosis and tubular atrophy on the new pathological classification in patients with diabetic nephropathy: a single-center study in China [J]. J Diabetes Complications, 2016, 30(3):537-541.
[14]	Molitch ME, Defronzo RA, Franz MJ, et al. Diabetic nephropathy [J]. Diabetes Care, 2003, 26(Suppl 1):S94-S98.
[15]	Mcknight AJ, Duffy S, Maxwell AP. Genetics of diabetic nephropathy: a long road of discovery [J]. Curr Diab Rep, 2015, 15(7):41.
[16]	Ma RC, Cooper ME. Genetics of diabetic kidney disease-from the worst of nightmares to the light of dawn? [J]. J Am Soc Nephrol, 2017, 28(2):389-393.
[17]	Ma RC. Genetics of cardiovascular and renal complications in diabetes [J]. J Diabetes Investig, 2016, 7(2):139-154.
[18]	Sandholm N, Van Zuydam N, Ahlqvist E, et al. The genetic landscape of renal complications in type 1 diabetes [J]. J Am Soc Nephrol, 2017, 28(2):557-574.
[19]	Colhoun HM, Marcovecchio ML. Biomarkers of diabetic kidney disease [J]. Diabetologia, 2018, 61(5):996-1011.
[20]	Narita T, Hosoba M, Kakei M, et al. Increased urinary excretions of immunoglobulin g, ceruloplasmin, and transferrin predict development of microalbuminuria in patients with type 2 diabetes [J]. Diabetes Care, 2006, 29(1):142-144.
[21]	Narita T, Sasaki H, Hosoba M, et al. Parallel increase in urinary excretion rates of immunoglobulin G, ceruloplasmin, transferrin, and orosomucoid in normoalbuminuric type 2 diabetic patients [J]. Diabetes Care, 2004, 27(5):1176-1181.
[22]	Hara M, Yamagata K, Tomino Y, et al. Urinary podocalyxin is an early marker for podocyte injury in patients with diabetes: establishment of a highly sensitive ELISA to detect urinary podocalyxin [J]. Diabetologia, 2012, 55(11):2913-2919.
[23]	Jim B, Ghanta M, Qipo A, et al. Dysregulated nephrin in diabetic nephropathy of type 2 diabetes: a cross sectional study [J]. PLoS One, 2012, 7(5):e36041.
[24]	Wickman L, Afshinnia F, Wang SQ, et al. Urine podocyte mRNAs, proteinuria, and progression in human glomerular diseases [J]. J Am Soc Nephrol, 2013, 24(12):2081-2095.
[25]	Nielsen SE, Reinhard H, Zdunek D, et al. Tubular markers are associated with decline in kidney function in proteinuric type 2 diabetic patients [J]. Diabetes Res Clin Pract, 2012, 97(1):71-76.
[26]	Araki S, Haneda M, Koya D, et al. Predictive effects of urinary liver-type fatty acid-binding protein for deteriorating renal function and incidence of cardiovascular disease in type 2 diabetic patients without advanced nephropathy [J]. Diabetes Care, 2013, 36(5):1248-1253.
[27]	Hong CY, Hughes K, Chia KS, et al. Urinary alpha1-microglobulin as a marker of nephropathy in type 2 diabetic Asian subjects in Singapore [J]. Diabetes Care, 2003, 26(2):338-342.
[28]	Garg V, Kumar M, Mahapatra HS, et al. Novel urinary biomarkers in pre-diabetic nephropathy [J]. Clin Exp Nephrol, 2015, 19(5):895-900.
[29]	Fu WJ, Li BL, Wang SB, et al. Changes of the tubular markers in type 2 diabetes mellitus with glomerular hyperfiltration [J]. Diabetes Res Clin Pract, 2012, 95(1):105-109.
[30]	Kim SS, Song SH, Kim IJ, et al. Urinary cystatin C and tubular proteinuria predict progression of diabetic nephropathy [J]. Diabetes Care, 2013, 36(3):656-661.
[31]	Barlovic DP, Zaletel J, Prezelj J. Adipocytokines are associated with renal function in patients with normal range glomerular filtration rate and type 2 diabetes [J]. Cytokine, 2009, 46(1):142-145.
[32]	Cawood TJ, Bashir M, Brady J, et al. Urinary collagen IV and piGST: potential biomarkers for detecting localized kidney injury in diabetes-a pilot study [J]. Am J Nephrol, 2010, 32(3):219-225.
[33]	Takahashi M. Increased urinary fibronectin excretion in type II diabetic patients with microalbuminuria [J]. Nihon Jinzo Gakkai Shi, 1995, 37(6):336-342.
[34]	Zheng M, Lv LL, Cao YH, et al. Urinary mRNA markers of epithelial-mesenchymal transition correlate with progression of diabetic nephropathy [J]. Clin Endocrinol (Oxf), 2012, 76(5):657-664.
[35]	Navarro JF, Mora C, Gomez M, et al. Influence of renal involvement on peripheral blood mononuclear cell expression behaviour of tumour necrosis factor-alpha and interleukin-6 in type 2 diabetic patients [J]. Nephrol Dial Transplant, 2008, 23(3):919-926.
[36]	Pavkov ME, Weil EJ, Fufaa GD, et al. Tumor necrosis factor receptors 1 and 2 are associated with early glomerular lesions in type 2 diabetes [J]. Kidney Int, 2016, 89(1):226-234.
[37]	Niewczas MA, Gohda T, Skupien J, et al. Circulating TNF receptors 1 and 2 predict ESRD in type 2 diabetes [J]. J Am Soc Nephrol, 2012, 23(3):507-515.
[38]	Gohda T, Niewczas MA, Ficociello LH, et al. Circulating TNF receptors 1 and 2 predict stage 3 CKD in type 1 diabetes [J]. J Am Soc Nephrol, 2012, 23(3):516-524.
[39]	Pavkov ME, Nelson RG, Knowler WC, et al. Elevation of circulating TNF receptors 1 and 2 increases the risk of end-stage renal disease in American Indians with type 2 diabetes [J]. Kidney Int, 2015, 87(4):812-819.
[40]	Yamanouchi M, Skupien J, Niewczas MA, et al. Improved clinical trial enrollment criterion to identify patients with diabetes at risk of end-stage renal disease [J]. Kidney Int, 2017, 92(1):258-266.
[41]	Lopes-Virella MF, Baker NL, Hunt KJ, et al. Baseline markers of inflammation are associated with progression to macroalbuminuria in type 1 diabetic subjects [J]. Diabetes Care, 2013, 36(8):2317-2323.
[42]	Navarro-Gonzalez JF, Mora-Fernandez C. The role of inflammatory cytokines in diabetic nephropathy [J]. J Am Soc Nephrol, 2008, 19(3):433-442.
[43]	Antonellis PJ, Kharitonenkov A, Adams AC. Physiology and endocrinology symposium: FGF21: insights into mechanism of action from preclinical studies [J]. J Anim Sci, 2014, 92(2):407-413.
[44]	Jian WX, Peng WH, Jin J, et al. Association between serum fibroblast growth factor 21 and diabetic nephropathy [J]. Metabolism, 2012, 61(6):853-859.
[45]	Kim HW, Lee JE, Cha JJ, et al. Fibroblast growth factor 21 improves insulin resistance and ameliorates renal injury in db/db mice [J]. Endocrinology, 2013, 154(9):3366-3376.
[46]	Bidadkosh A, Lambooy S, Heerspink HJ, et al. Predictive properties of biomarkers GDF-15, NTproBNP, and hs-TnT for morbidity and mortality in patients with type 2 diabetes with nephropathy [J]. Diabetes Care, 2017, 40(6):784-792.
[47]	Verhave JC, Bouchard J, Goupil R, et al. Clinical value of inflammatory urinary biomarkers in overt diabetic nephropathy: a prospective study [J]. Diabetes Res Clin Pract, 2013, 101(3):333-340.
[48]	Neal B, Perkovic V, Mahaffey KW, et al. Canagliflozin and cardiovascular and renal events in type 2 diabetes [J]. N Engl J Med, 2017, 377(7):644-657.
[49]	Madaan T, Akhtar M, Najmi AK. Sodium glucose cotransporter 2 (SGLT2) inhibitors: current status and future perspective [J]. Eur J Pharm Sci, 2016, 93:244-252.
[50]	Tanaka T, Higashijima Y, Wada T, et al. The potential for renoprotection with incretin-based drugs [J]. Kidney Int, 2014, 86(4):701-711.
[51]	Yoon KH, Nishimura R, Lee J, et al. Efficacy and safety of empagliflozin in patients with type 2 diabetes from Asian countries: pooled data from four phase Ⅲ trials [J]. Diabetes Obes Metab, 2016, 18(10):1045-1049.
[52]	Mann J, Orsted DD, Brown-Frandsen K, et al. Liraglutide and renal outcomes in type 2 diabetes [J]. N Engl J Med, 2017, 377(9):839-848.
[53]	Giugliano D, Maiorino MI, Bellastella G, et al. Type 2 diabetes and cardiovascular prevention: the dogmas disputed [J]. Endocrine, 2018, 60(2):224-228.
[54]	Practice ERB. Clinical practice guideline on management of patients with diabetes and chronic kidney disease stage 3b or higher (eGFR <45 mL/min) [J]. Nephrol Dial Transplant, 2015, 30(Suppl 2):i1-i142.
[55]	Giugliano D, Maiorino MI, Bellastella G, et al. Type 2 diabetes and cardiovascular prevention: the dogmas disputed [J]. Endocrine, 2018, 60(2):224-228.
[56]	American Diabetes Association. Glycemic targets: standards of medical care in diabetes-2018 [J]. Diabetes Care, 2018, 41(Suppl 1):S55-S64.
[57]	Tong L, Adler SG. Diabetic kidney disease [J]. Clin J Am Soc Nephrol, 2018, 13(2):335-338.
[58]	Parvanova A, Trillini M, Podesta MA, et al. Moderate salt restriction with or without paricalcitol in type 2 diabetes and losartan-resistant macroalbuminuria (PROCEED): a randomised, double-blind, placebo-controlled, crossover trial [J]. Lancet Diabetes Endocrinol, 2018, 6(1):27-40.
[59]	American Diabetes Association. Cardiovascular disease and risk management: standards of medical care in Diabetes-2018 [J]. Diabetes Care, 2018, 41(Suppl 1):S86-S104.
[60]	Umanath K, Lewis JB. Update on diabetic nephropathy: core curriculum 2018 [J]. Am J Kidney Dis, 2018, 71(6):884-895.
[61]	中国医师协会肾脏内科医师分会，中国中西医结合学会肾脏疾病专业委员会. 中国肾性高血压管理指南2016(简版)[J]. 中华医学杂志，2017，97(20):1547-1555.
[62]	Valensi P, Picard S. Lipids, lipid-lowering therapy and diabetes complications [J]. Diabetes Metab, 2011, 37(1):15-24.
[63]	Almquist T, Jacobson SH, Mobarrez F, et al. Lipid-lowering treatment and inflammatory mediators in diabetes and chronic kidney disease [J]. Eur J Clin Invest, 2014, 44(3):276-284.
[64]	American Diabetes Association. Obesity management for the treatment of type 2 diabetes: standards of medical care in diabetes-2018 [J]. Diabetes Care, 2018, 41(Suppl 1):S65-S72.
[65]	Oellgaard J, Gaede P, Rossing P, et al. Intensified multifactorial intervention in type 2 diabetics with microalbuminuria leads to long-term renal benefits [J]. Kidney Int, 2017, 91(4):982-988.

Please choose a citation manager

Content to export