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Life
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Updates on Diabetic Nephropathy
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Updates on Diabetic Nephropathy

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Physiology and Pathology".

Deadline for manuscript submissions: closed (7 July 2023) | Viewed by 5294

Special Issue Editors

Dr. Maria Chiara Pelle

E-Mail Website
Guest Editor
Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, 88100 Catanzaro, Italy
Interests: diabetes mellitus type 2; diabetic nephropathy; obesity; cardiovascular risk; insulin sensitivity; hyperglycemia
Dr. Michele Provenzano

E-Mail Website
Guest Editor
Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy
Interests: epidemiology, prognosis and treatment of chronic kidney disease patients; cardiovascular risk; kidney transplant; hemodialysis; peritoneal dialysis
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The prevalence of diabetes mellitus (DM) has increased more rapidly in low- and middle-income countries than in high-income countries. At present, 537 million adults between the ages of 20 and 79 years suffer from DM2. Uncontrolled DM leads to serious injury to many of the body's systems, such us nerves, eyes, heart and kidney. Particularly, diabetic nephropathy (DN) is a chronic complication of DM that leads to CKD progression and is also associated with an increased cardiovascular (CV) risk. This Special Issue is open to articles targeting updates to diabetic nephropathy. Recent studies have highlighted the need to better stratify the future risk of patients with DN. In fact, a non-negligible proportion of DN patients present a significant progressive decline in renal function without developing albuminuria (which is considered the main marker of kidney damage, especially during DN). DN is therefore a heterogeneous disease for its clinical manifestations, histopathology and the rate of progression, which makes it difficult to develop effective therapies. Glycemic control and blood pressure management play an important role in improving the management of DN patients, but the current therapy cannot completely reduce kidney disease progression and CV risk. Therefore, we wish to initiate the interest of researchers focusing on this topic. The pathophysiology of DN is mediated by several pathways (polyol chain, AGE, and NADPH oxidase, Nox) which raise the production of reactive oxygen species (ROS). Considering the high interest in the development of emerging challenges for modern therapies for the treatment of DM, this Special Issue will help to improve the knowledge of the renoprotective role of these therapeutic agents in addition to their glucose-lowering effects, and on top of the standard of care used in DN patients (namely, renin–angiotensin–aldosterone system inhibitors). We welcome scientific papers including reviews, opinions, communications, original research articles, and others from everywhere around the world.

Dr. Maria Chiara Pelle
Dr. Michele Provenzano
Guest Editors

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Keywords

  • diabetic nephropathy
  • hyperglycemia
  • kidney disease
  • therapeutics
  • molecular pathway

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Published Papers (2 papers)

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Research

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12 pages, 492 KiB  
Article
The Diagnostic Performance of a Clinical Diagnosis of Diabetic Kidney Disease
by Ken-Soon Tan, Stephen McDonald and Wendy Hoy
Life 2023, 13(7), 1492; https://doi.org/10.3390/life13071492 - 30 Jun 2023
Cited by 1 | Viewed by 1557
Abstract
Background: Diabetic kidney disease (DKD), a common cause of CKD and kidney failure, is usually diagnosed clinically. However, there is little evidence comparing the performance of a clinical diagnosis to biopsy-proven diagnosis. Purpose of the study: Diagnostic performance of a clinical diagnosis was [...] Read more.
Background: Diabetic kidney disease (DKD), a common cause of CKD and kidney failure, is usually diagnosed clinically. However, there is little evidence comparing the performance of a clinical diagnosis to biopsy-proven diagnosis. Purpose of the study: Diagnostic performance of a clinical diagnosis was determined in a group of patients with diabetes and chronic kidney disease who underwent kidney biopsy after an initial clinical diagnosis. Methods: A data analysis of 54 patients who were part of a study cohort for a prospective analysis of cardiovascular and kidney outcomes and who had undergone kidney biopsy after an initial clinical diagnosis of DKD or non-DKD (NDKD) at enrolment was used. We determined the sensitivity, specificity, and positive and negative predictive values of a clinical diagnosis of DKD. Results: A total of 37 of 43 patients clinically diagnosed with DKD also had biopsy-proven DKD, whilst only 1 of 11 patients who had clinically diagnosed NDKD had biopsy-proven DKD. Sensitivity was 97.4%, specificity was 62.5%, positive predictive value 86%, and negative predictive value 90.9%. Comparable values were obtained when analysis was restricted to those with primary rather than secondary diagnosis of DKD or when restricted to those with only DKD found at biopsy. Conclusion: A clinical diagnosis of DKD has high sensitivity and is unlikely to overlook cases but may lead to overdiagnosis. Full article
(This article belongs to the Special Issue Updates on Diabetic Nephropathy)
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Review

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24 pages, 1555 KiB  
Review
Novel Drugs for the Management of Diabetes Kidney Transplant Patients: A Literature Review
by Nancy Daniela Valencia-Morales, Beatriz Rodríguez-Cubillo, Rómulo Katsu Loayza-López, Maria Ángeles Moreno de la Higuera and Ana Isabel Sánchez-Fructuoso
Life 2023, 13(6), 1265; https://doi.org/10.3390/life13061265 - 26 May 2023
Cited by 1 | Viewed by 3032
Abstract
The management of diabetes and renal failure is changing thanks to the appearance of new drugs such as glucagon-like peptide 1 receptor agonists (GLP1-RA) and sodium-glucose cotransporter type 2 inhibitors (SGLT2i) that have benefits in terms of survival and cardiorenal protection. Based on [...] Read more.
The management of diabetes and renal failure is changing thanks to the appearance of new drugs such as glucagon-like peptide 1 receptor agonists (GLP1-RA) and sodium-glucose cotransporter type 2 inhibitors (SGLT2i) that have benefits in terms of survival and cardiorenal protection. Based on the potential mechanisms of GLP1-RA, kidney transplant recipients (KTRs) could benefit from their effects. However, high-quality studies are needed to demonstrate these benefits, in the transplant population, especially those related to cardiovascular benefits and renal protection. Studies with SGLT2i performed in KTRs are much less potent than in the general population and therefore no benefits in terms of patient or graft survival have been clearly demonstrated in this population to date. Additionally, the most frequently observed side effects could be potentially harmful to this population profile, including severe or recurrent urinary tract infections and impaired kidney function. However, benefits demonstrated in KTRs are in line with a known potential effects in cardiovascular and renal protection, which may be essential for the outcome of transplant recipients. Better studies are still needed to confirm the benefits of these new oral antidiabetics in the renal transplant population. Understanding the characteristics of these drugs may be critical for KTRs to be able to benefit from their effects without being damaged. This review discusses the results of the most important published studies on KTRs with GLP1-RA and SGLT2i as well as the potential beneficial effects of these drugs. Based on these results, approximate suggestions for the management of diabetes in KTRs were developed. Full article
(This article belongs to the Special Issue Updates on Diabetic Nephropathy)
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