Diabetic kidney disease in patients newly diagnosed with type-2 diabetes mellitus: Incidence and associations

Aboelnasr, Mohamed Sabry; Shaltout, Ahmed Kotb; AlSheikh, Mabrouk Ramadan; Abdelhameed, Amal Helmy; Elrefaey, Waleed

doi:10.4103/1319-2442.279940

Cited by 13 publications

(21 citation statements)

References 29 publications

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“…Concurrent with HTN, which occurs in approximately 65% of patients with DM, hyperglycemia, and genetic predisposition are key factors in the development and progression of kidney disease [8,13]. DN is characterized by the development of proteinuria with a subsequent decline in eGFR [6,8,11]. Although increasing urinary albumin excretion and serum Cr levels accompanied with diminished eGFR are likely important markers of kidney decline, it is unclear whether these biomarkers are independent risk factors for the progression of kidney disease or subsequent outcomes in patients with type 2 DM [8,16].…”

Section: Cardiovascular and Cerebrovascular Prognosismentioning

confidence: 99%

“…Fourth, the prevalence rate of HTN and RASi treatment were different between the microalbuminuria and macroalbuminuria groups. HTN and RASi treatment can affect renal prognosis and might have introduced a bias [6,26,27]. However, there was no signi cant difference in the prevalence rate of HTN and RASi treatment between the moderately increased albuminuria group and severely increased albuminuria group despite the signi cant difference in renal prognosis between the moderately increased albuminuria group and severely increased albuminuria group.…”

Section: Cardiovascular and Cerebrovascular Prognosismentioning

confidence: 99%

“…The incidence and prevalence of type 2 diabetes mellitus (DM) in adults are increasing, and diabetic nephropathy (DN), one of the most common complications of DM that develops in approximately 40% of the patients, has become the leading cause of end-stage renal disease (ESRD) in developed countries [1][2][3][4]. DN is usually a clinical diagnosis based on the presence of albuminuria and/or reduced estimated glomerular ltration rate (eGFR) in the absence of signs or symptoms of other primary causes of kidney damage [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

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Progression to Chronic Kidney Disease According to Albuminuria in Diabetic Nephropathy Patients With Preserved Renal Function

Hr¹,

Kr²,

Lee³

et al. 2020

Preprint

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Background: Albuminuria predicts progression of diabetic nephropathy (DN) but lacks specificity and sensitivity for the diagnosis of chronic kidney disease (CKD) and progressive decline in estimated glomerular filtration rate (eGFR). We evaluated the decline in renal function in patients with DN and analyzed the prognosis of renal function according to the level of albuminuria and the incidence of cardiovascular disease (CVD), cerebrovascular diseases, and peripheral artery disease (PAD) according to the level of albuminuria. Methods: This retrospective study included 331 patients with eGFR > 60 mL/min/1.73 m2 and urinary albumin/creatinine (Cr) ratio (ACR) > 30 mg/g Cr who were treated at the Chungnam National University Hospital between January 2012 and December 2018. Patients were divided into mildly increased albuminuria, moderately increased albuminuria, and severely increased albuminuria groups according to their urine ACRs of 30–300, 300–900, and >900 mg/g Cr, respectively. Renal outcomes and incidence of CVD, cerebrovascular disease, and PAD were compared among the three groups.Results: The rate of reduction in eGFR per year was 1.47 ± 6.61 mL/min/1.73 m2 in the mildly increased albuminuria, 4.10 ± 8.98 mL/min/1.73 m2 in the moderately increased albuminuria, and 9.19 ± 10.39 mL/min/1.73 m2 in the severely increased albuminuria (p < 0.001). More severe albuminuria was associated with higher rates of progression to CKD (p < 0.001) and >50% reduction in eGFR from baseline (p < 0.001). There was a statistically significant difference in the rate of PCI with angina or myocardial infarction (p = 0.030). However, cerebrovascular disease and PAD did not significantly differ among the three groups.Conclusion: Among patients with DN who maintained a relatively preserved renal function with an eGFR > 60 mL/min/1.73 m2, the rates of renal deterioration and progression to CKD were significantly more frequent in those with more severe albuminuria.

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Section: Cardiovascular and Cerebrovascular Prognosismentioning

confidence: 99%

Section: Cardiovascular and Cerebrovascular Prognosismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Progression to Chronic Kidney Disease According to Albuminuria in Diabetic Nephropathy Patients With Preserved Renal Function

Hr¹,

Kr²,

Lee³

et al. 2020

Preprint

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“…1 The prevalence of type II diabetes mellitus (T2DM) increases with age across all regions and income groups. 2 Still, the prevalence is increasing in young age groups due to unhealthy life routines present since childhood. 3 Insulin resistance (IR) associates with T2DM.…”

Section: Introductionmentioning

confidence: 99%

T-Natural Killers and Interferon Gamma/Interleukin 4 in Augmentation of Infection in Foot Ulcer in Type 2 Diabetes

Hammad

Elmadbouly

Ahmad

et al. 2021

DMSO

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Background The link between immune system and type 2 diabetes mellitus (T2DM) pathogenesis attracted attention to demonstrate the role of immune cells and their secreted cytokines in T2DM development and its subsequent foot complications. Objective To investigate the relation between T Natural killer cell (TNK) %, Interleukin 4 (IL4) and Interferon gamma (IFN-γ) and diabetic foot infection (DFI) development in patients with diabetic foot ulcer (DFU). Patients and Methods Ninety patients with diabetes were included in this work, divided as T2DM group (n=30), DFU group (n=30), and DFI group (n=30). TNK% was detected using flow cytometry. Serum IL4 and IFN-γ were measured by ELISA. Diabetes biochemical parameters were also analyzed. Results Significant decrease was detected in TNK% and IFN-γ in DFI group compared to other 2 groups ( P <0.001). Significant decrease was detected in serum levels of IL4 in DFI group compared to T2DM group ( P =0.006). IFN-γ/IL4 was significantly decreased in DFI compared to DFU group ( P =0.020). There was a significant correlation of TNK% with both IL4 and IFN-γ (r=0.385, P <0.001; r=0.534, P <0.001, respectively). Significant negative correlation of TNK% with HbA1c and LDL was revealed (r=−0.631, P <0.001; and r=−0.261, P =0.013, respectively), while a positive correlation was seen with HDL (r=0.287, P =0.006). A significant negative correlation of IL4 with HbA1c was found (r=−0.514, P <0.001;. As for IFN-γ, a significant negative correlation with HbA1c and LDL was detected (r=−0.369, P < 0.001; r=−0.229, P =0.030). TNK % and IFN-γ level showed negative correlations with disease duration/year (r=−0.546, P < 0.001; r=−0.338, P =0.001,respectively). Conclusion Decline in TNK frequency has essential role in T2DM pathogenesis and subsequent foot complications. Downregulation of TNK% and IFN-γ level have potential roles in predicting infection of diabetic ulcer and are correlated with disease duration.

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“…The global incidence of type 2 diabetes (T2D) in adults is increasing worldwide [ 1 ]. It is a complex disease affected by many factors and complications.…”

Section: Introductionmentioning

confidence: 99%

Pathway‐based protein–protein association network to explore mechanism ofα‐glucosidase inhibitors fromScutellaria baicalensisGeorgi against type 2 diabetes

Wang

Diwu

Tan

et al. 2021

IET Systems Biology

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Natural products have been widely used in the treatment of type 2 diabetes (T2D). However, their mechanisms are often obscured due to multi‐components and multi‐targets. The authors constructed a pathway‐based protein–protein association (PPA) network for target proteins of 13 α‐glucosidase inhibitors (AGIs) identified from Scutellaria baicalensis Georgi ( SBG ), designed to explore the underlying mechanisms. This network contained 118 nodes and 1167 connections. An uneven degree distribution and small‐world property were observed, characterised by high clustering coefficient and short average path length. The PPA network had an inherent hierarchy as C(k)∼k −0.71 . It also exhibited potential weak disassortative mixing pattern, coupled with a decreased function Knn ( k ) and negative value of assortativity coefficient. These properties indicated that a few nodes were crucial to the network. PGH2, GNAS, MAPK1, MAPK3, PRKCA, and MAOA were then identified as key targets with the highest degree values and centrality indices. Additionally, a core subnetwork showed that chrysin, 5,8,2′‐trihydroxy‐7‐methoxyflavone, and wogonin were the main active constituents of these AGIs, and that the serotonergic synapse pathway was the critical pathway for SBG against T2D. The application of a pathway‐based protein–protein association network provides a novel strategy to explore the mechanisms of natural products on complex diseases.

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Diabetic kidney disease in patients newly diagnosed with type-2 diabetes mellitus: Incidence and associations

Cited by 13 publications

References 29 publications

Progression to Chronic Kidney Disease According to Albuminuria in Diabetic Nephropathy Patients With Preserved Renal Function

Progression to Chronic Kidney Disease According to Albuminuria in Diabetic Nephropathy Patients With Preserved Renal Function

T-Natural Killers and Interferon Gamma/Interleukin 4 in Augmentation of Infection in Foot Ulcer in Type 2 Diabetes

Pathway‐based protein–protein association network to explore mechanism ofα‐glucosidase inhibitors fromScutellaria baicalensisGeorgi against type 2 diabetes

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