Renal Hyperfiltration in Adolescents with Type 2 Diabetes: Physiology, Sex Differences, and Implications for Diabetic Kidney Disease

Bjornstad, Petter; Cherney, David Z.I.

doi:10.1007/s11892-018-0996-2

Cited by 42 publications

(39 citation statements)

References 61 publications

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“…As will be discussed below, sex hormones are thought to regulate renal hemodynamics, oxidative stress, inflammation, and key biological pathways involved in the pathophysiology of DKD. 42,[63][64][65][66] Other general factors that lead to DKD in a sex-specific manner include: type and duration of diabetes, biological age, age at onset of diabetes, and genetic and epigenetic factors, et cetera. 67,68 Classical risk factors for DKD, including glycemic control, hypertension, obesity, and dyslipidemia have also been reported to differentially contribute to disease pathophysiology according to sex.…”

Section: Mechanisms Underlying Sex Differ-ences In Dkdmentioning

confidence: 99%

“…105 In the Treatment Options for T2DM in Adolescents and Youth (TODAY) study, girls had higher eGFR levels at baseline compared with boys, and a three-fold greater risk of developing hyperfiltration over 5 years, even after adjustment for age, ethnicity, treatment group, body mass index, HbA 1c , hypertension, glycemic control, and estimated insulin sensitivity. 63 This evidence for the role of sex the regulation of renal hemodynamics comes from experimental models and studies in adolescents in early stages of DKD. Studies examining the impact of sex on renal hemodynamic changes associated with advanced stages of DKD are clearly needed.…”

Section: Sex Differences In Renal Hemodynamicsmentioning

confidence: 99%

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Sex Differences in Diabetic Kidney Disease

Maric‐Bilkan

2020

Mayo Clinic Proceedings

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While the global prevalence of both type 1 and type 2 diabetes mellitus is similar in men and women, the consequences of diabetes on associated end-organ complications, including diabetic kidney disease appear to be more sex-specific. Particularly, women with diabetes have higher mortality rates for diabetes-related deaths, and higher prevalence of diabetic kidney disease risk factors such as hypertension, hyperglycemia, obesity, and dyslipidemia. However, the evidence for the impact of sex on diabetic kidney disease prevalence and disease progression is limited and inconsistent. Although most studies agree that the protective effect of the female sex against the development of kidney disease is diminished in the setting of diabetes, the reasons for this observation are unclear. Whether or not sex differences exist in the risk of diabetic kidney disease is also unclear, with studies reporting either higher risk in men, women, or no sex differences. Despite the remaining controversies, some of the factors that associate with sex differences in the risk of diabetic kidney disease are age at onset, and type and duration of diabetes. There is growing appreciation of the importance of sex hormones in the regulation of renal function, with estrogens generally considered to be renoprotective. Although some progress has been made towards better understanding of the mechanisms by which sex hormones play a role in the pathophysiology of diabetic kidney disease, the translational potential

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Section: Mechanisms Underlying Sex Differ-ences In Dkdmentioning

confidence: 99%

Section: Sex Differences In Renal Hemodynamicsmentioning

confidence: 99%

Sex Differences in Diabetic Kidney Disease

Maric‐Bilkan

2020

Mayo Clinic Proceedings

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“…HUA is just one of many conditions that have observable sex differences, as differing pathologies based on sex have been observed in a variety of fields [14][15][16][17] including cardiovascular [18][19][20][21], neurological [22][23][24][25], immunological [26][27][28], and renal diseases [29][30][31][32][33]. The architecture of the female kidney is likely distinct from that of the male kidney [34], given women have a lower blood pressure than men [35], women are less likely to develop acute kidney injury than men [36,37], women demonstrate improved tolerance to renal ischemia [38,39], and women are protected from renal and cardiovascular disease before menopause as compared to men [40,41].…”

Section: Urate As a Risk Factor In Diseasementioning

confidence: 99%

Sex Differences in Urate Handling

Kuhns

Woodward

2020

IJMS

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Hyperuricemia, or elevated serum urate, causes urate kidney stones and gout and also increases the incidence of many other conditions including renal disease, cardiovascular disease, and metabolic syndrome. As we gain mechanistic insight into how urate contributes to human disease, a clear sex difference has emerged in the physiological regulation of urate homeostasis. This review summarizes our current understanding of urate as a disease risk factor and how being of the female sex appears protective. Further, we review the mechanisms of renal handling of urate and the significant contributions from powerful genome-wide association studies of serum urate. We also explore the role of sex in the regulation of specific renal urate transporters and the power of new animal models of hyperuricemia to inform on the role of sex and hyperuricemia in disease pathogenesis. Finally, we advocate the use of sex differences in urate handling as a potent tool in gaining a further understanding of physiological regulation of urate homeostasis and for presenting new avenues for treating the constellation of urate related pathologies.

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“…Diabetic nephropathy, or diabetic kidney disease, is the leading cause of end-stage renal disease (ESRD), with more than half of all cases attributed to these metabolic disorders (7). The kidney is responsible for filtering all blood glucose, and under conditions of hyperglycemia, the increased filtered load has been shown to induce oxidative damage and induce injury to the delicate vasculature and surrounding tubules (10).…”

mentioning

confidence: 99%

Sex differences in diabetes and kidney disease: mechanisms and consequences

Shepard

2019

American Journal of Physiology-Renal Physiology

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Type 1 and type 2 diabetes, along with their accompanying hyperglycemia, are associated with a multitude of comorbidities including the development of diabetic kidney disease. Although the hallmarks of these metabolic disorders have been well characterized in population and animal studies, it is becoming increasingly apparent that diabetes manifests itself differently in men and women. This review summarizes the recent diabetic literature with a focus on known sex differences in clinical and preclinical studies. It explores the physiological differences of glucose handling and the development of diabetes between men and women. This review also uncovers potential mechanisms for these differences, honing in on the vital role that sex hormone signaling plays in the progression of diabetes and renal complications.

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Renal Hyperfiltration in Adolescents with Type 2 Diabetes: Physiology, Sex Differences, and Implications for Diabetic Kidney Disease

Cited by 42 publications

References 61 publications

Sex Differences in Diabetic Kidney Disease

Sex Differences in Diabetic Kidney Disease

Sex Differences in Urate Handling

Sex differences in diabetes and kidney disease: mechanisms and consequences

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