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Glucose and Blood Pressure-Dependent Pathways–The Progression of Diabetic Kidney Disease

1
Department of Diabetes, Monash University Central, Clinical School, Melbourne, VIC 3004, Australia
2
Department of Endocrinology and Diabetes, The Alfred Hospital, Melbourne, VIC 3004, Australia
*
Authors to whom correspondence should be addressed.
Int. J. Mol. Sci. 2020, 21(6), 2218; https://doi.org/10.3390/ijms21062218
Received: 20 February 2020 / Revised: 17 March 2020 / Accepted: 17 March 2020 / Published: 23 March 2020
(This article belongs to the Special Issue Molecular Mechanisms Involved in Diabetic Nephropathy)
The major clinical associations with the progression of diabetic kidney disease (DKD) are glycemic control and systemic hypertension. Recent studies have continued to emphasize vasoactive hormone pathways including aldosterone and endothelin which suggest a key role for vasoconstrictor pathways in promoting renal damage in diabetes. The role of glucose per se remains difficult to define in DKD but appears to involve key intermediates including reactive oxygen species (ROS) and dicarbonyls such as methylglyoxal which activate intracellular pathways to promote fibrosis and inflammation in the kidney. Recent studies have identified a novel molecular interaction between hemodynamic and metabolic pathways which could lead to new treatments for DKD. This should lead to a further improvement in the outlook of DKD building on positive results from RAAS blockade and more recently newer classes of glucose-lowering agents such as SGLT2 inhibitors and GLP1 receptor agonists. View Full-Text
Keywords: diabetic kidney disease; diabetic nephropathy; diabetic complications; vasoactive pathways diabetic kidney disease; diabetic nephropathy; diabetic complications; vasoactive pathways
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Patel, D.M.; Bose, M.; Cooper, M.E. Glucose and Blood Pressure-Dependent Pathways–The Progression of Diabetic Kidney Disease. Int. J. Mol. Sci. 2020, 21, 2218.

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