Kidney hemodynamic profile and systemic vascular function in adults with type 2 diabetes: Analysis of three clinical trials

Hesp, Anne C.; Smits, Mark M.; Bommel, Erik J.M. van; Muskiet, Marcel H.A.; Tonneijck, Lennart; Nieuwdorp, Max; Kramer, Mark H. H.; Joles, Jaap A.; Bjornstad, Petter; Raalte, Daniël H. van

doi:10.1016/j.jdiacomp.2022.108127

Cited by 3 publications

(2 citation statements)

References 38 publications

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“…Elevated plasma ET-1 levels have been found in T2DM, which leads to endothelial dysfunction ( 132 ). Recently, in a three-clinical-trial analysis, the kidney hemodynamic profile in adults with type 2 diabetes showed that endothelial dysfunction is associated with glomerular hyperfiltration ( 133 ). Evidence suggests that the vasoconstrictive effect of endothelin is amplified in DKD ( 129 , 130 ).…”

Section: Vascular Mechanisms For Hyperfiltration In Early Diabetic Ki...mentioning

confidence: 99%

Update on Pathogenesis of Glomerular Hyperfiltration in Early Diabetic Kidney Disease

Yang

2022

Front. Endocrinol.

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In the existing stages of diabetic kidney disease (DKD), the first stage of DKD is called the preclinical stage, characterized by glomerular hyperfiltration, an abnormally elevated glomerular filtration rate. Glomerular hyperfiltration is an independent risk factor for accelerated deterioration of renal function and progression of nephropathy, which is associated with a high risk for metabolic and cardiovascular disease. It is imperative to understand hyperfiltration and identify potential treatments to delay DKD progress. This paper summarizes the current mechanisms of hyperfiltration in early DKD. We pay close attention to the effect of glucose reabsorption mediated by sodium–glucose cotransporters and renal growth on hyperfiltration in DKD patients, as well as the mechanisms of nitric oxide and adenosine actions on renal afferent arterioles via tubuloglomerular feedback. Furthermore, we also focus on the contribution of the atrial natriuretic peptide, cyclooxygenase, renin–angiotensin–aldosterone system, and endothelin on hyperfiltration. Proposing potential treatments based on these mechanisms may offer new therapeutic opportunities to reduce the renal burden in this population.

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Section: Vascular Mechanisms For Hyperfiltration In Early Diabetic Ki...mentioning

confidence: 99%

Update on Pathogenesis of Glomerular Hyperfiltration in Early Diabetic Kidney Disease

Yang

2022

Front. Endocrinol.

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“…However, whether or not this could have affected our results is not clear. Probably, the use of other noninvasive methods of continuous systemic blood pressure evaluation, such as ambulatory or beat-to-beat blood pressure monitoring, might have better represented the relationship between intrarenal and systemic hemodynamic changes [41, 42]. Third, we did not have data about albuminuria after bosentan treatment.…”

Section: Discussionmentioning

confidence: 99%

Bosentan Does Not Affect Renal Resistive Index in Scleroderma/Systemic Sclerosis Patients

Di Poi,

Colussi,

Bertoni

et al. 2023

Kidney Blood Press Res

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Introduction: If properly evaluated, chronic kidney disease can be found in up to 50% of patients with systemic sclerosis (SSc). The renal resistive index (RRI) is a marker of intrarenal vascular resistance and can predict SSc-associated vasculopathy. This study aimed to determine the impact of bosentan, a nonselective endothelin-1 receptor antagonist, on RRI and kidney function in SSc patients with recurrent digital ulcers. Methods: Twenty-one patients (age 57 ± 9 years, 19 females) were recruited in a 16-week prospective open-label uncontrolled study. Standardized procedures were used to measure general clinical and laboratory characteristics, systolic, diastolic, and mean arterial pressure (MAP), pulse pressure (PP), diastolic to systolic blood pressure (D/S) ratio, and urinary endothelin-1 levels. The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation was used to calculate kidney function as an estimated glomerular filtration rate (eGFR). RRI was measured by Doppler ultrasound as the average of three samplings of intrarenal blood flow in different kidney regions of both kidneys. Patients with secondary causes of kidney disease or kidney diseases associated with albuminuria were excluded. Results: Bosentan treatment for 16 weeks did not change RRI (0.731 ± 0.049–0.730 ± 0.054, p = 0.925), but increased urine endothelin-1 to creatinine ratio (0.27 ± 0.15–0.49 ± 0.57 pg/mg, p = 0.032) and reduced MAP (123 ± 10–101 ± 11 mm Hg, p < 0.001), PP (76 ± 11–68 ± 10 mm Hg, p = 0.003), D/S ratio (0.563 ± 0.044–0.538 ± 0.031, p = 0.006), and eGFR (92 ± 20–84 ± 24 mL/min/1.73 m2, p = 0.003). Discussion/Conclusion: In conclusion, in patients with SSc complicated by digital ulcers and normal to mildly diminished kidney function, bosentan had no effect on intrarenal hemodynamics, but reduced blood pressure levels and kidney function.

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Renal hemodynamic changes in patients with type 2 diabetes and their clinical impact

Saulnier,

Bjornstad

2023

La Presse Médicale

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Kidney hemodynamic profile and systemic vascular function in adults with type 2 diabetes: Analysis of three clinical trials

Cited by 3 publications

References 38 publications

Update on Pathogenesis of Glomerular Hyperfiltration in Early Diabetic Kidney Disease

Update on Pathogenesis of Glomerular Hyperfiltration in Early Diabetic Kidney Disease

Bosentan Does Not Affect Renal Resistive Index in Scleroderma/Systemic Sclerosis Patients

Renal hemodynamic changes in patients with type 2 diabetes and their clinical impact

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