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Update on Diabetic Nephropathy: Recent Progress and Future Perspective
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Update on Diabetic Nephropathy: Recent Progress and Future Perspective

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Nephrology & Urology".

Deadline for manuscript submissions: closed (31 October 2021) | Viewed by 22612

Special Issue Editors

Prof. Dr. Loreto Gesualdo

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Guest Editor
The Nephrology, Dialysis and Transplantation Unit "Aldo Moro", University of Bari, Azienda Ospedaliero-Universitaria Consorziale "Policlinico", Piazza Giulio Cesare, 11-70124 Bari, Italy
Interests: kidney disease; diabetic nephropathy; nephropathology; kidney transplantation; renal pathology; dialysis
Dr. Paola Pontrelli

E-Mail Website
Guest Editor
Nephrology, Dialysis and Transplantation Unit, Department of Emergency and Organ Transplantation, University of Bari Aldo Moro, 70124 Bari, Italy
Interests: genomics; transcriptomics; diabetic nephropathy; kidney transplantation
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues, 

Diabetic kidney disease affects approximately 40% of all diabetic patients and is the leading cause of chronic kidney disease (CKD) worldwide. Kidney damage in diabetes is mostly known as diabetic nephropathy; however, renal lesions in diabetic patients can be heterogeneous.

Latest advances in antidiabetic therapies have been shown to mitigate disease progression in terms of cardiovascular complications and renal damage. Recent clinical trials highlight the possibility to refine the management of type 2 diabetes and improve renal outcomes.

Several mechanisms can drive disease progression in diabetic nephropathy, and research has focused on different areas, including animal models, hypothesis-driven biomarkers, and “-omics” platforms, such as genomics, transcriptomics, metabolomics, and proteomics. Over the last few decades, a growing body of evidence has shown how the integration of systems biology data coming from “-omics” platforms can better describe the complexity of biological systems and help to predict how these change over time and under varying conditions, and to develop solutions to the world’s most pressing health and environmental issues. Finally, novel approaches based on artificial intelligence are emerging with the aim to transform diabetes care, support clinical decisions, improve population risk stratification, and develop tools for patients self-management.

Prof. Dr. Loreto Gesualdo
Dr. Paola Pontrelli
Guest Editors

Manuscript Submission Information

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Keywords

  • diabetic nephropathy
  • antidiabetic drugs
  • omics techniques
  • system biology
  • biomarkers
  • artificial intelligence

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Published Papers (2 papers)

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Research

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12 pages, 295 KiB  
Article
Genetics Variants in the Epoxygenase Pathway of Arachidonic Metabolism Are Associated with Eicosanoids Levels and the Risk of Diabetic Nephropathy
by Sonia Mota-Zamorano, Nicolás R. Robles, Luz M. González, José M. Valdivielso, Juan Lopez-Gomez, Bárbara Cancho, Guadalupe García-Pino and Guillermo Gervasini
J. Clin. Med. 2021, 10(17), 3980; https://doi.org/10.3390/jcm10173980 - 2 Sep 2021
Cited by 8 | Viewed by 2717
Abstract
Genes in the epoxygenase pathway of arachidonic acid metabolism leading to vasoactive eicosanoids, mainly 20-hydroxyeicosatetraenoic (20-HETE) and epoxyeicosatrienoic (EETs) acids, have been related to glucose-induced renal damage in preclinical reports. We genotyped 1088 diabetic kidney disease (DKD) patients and controls for seven polymorphisms [...] Read more.
Genes in the epoxygenase pathway of arachidonic acid metabolism leading to vasoactive eicosanoids, mainly 20-hydroxyeicosatetraenoic (20-HETE) and epoxyeicosatrienoic (EETs) acids, have been related to glucose-induced renal damage in preclinical reports. We genotyped 1088 diabetic kidney disease (DKD) patients and controls for seven polymorphisms in five genes (CYP2C8, CYP2J2, CYP4F2, CYP4A11, and EPHX2) along this metabolic route and evaluated their effect on DKD risk, clinical outcomes, and the plasma/urine levels of eicosanoids measured by LC/MS/MS and immunoenzymatic assays. The CYP4F2 433M variant allele was associated with lower incidence of DKD (OR = 0.65 (0.48–0.90), p = 0.008), whilst the CYP2C8*3/*3 genotype was related to increased risk (OR = 3.21 (1.05–9.87), p = 0.036). Patients carrying the 433M allele also showed lower eGFR [median and interquartile range vs. wildtype carriers: 30.8 (19.8) and 33.0 (23.2) mL/min/1.73 m2, p = 0.037). Finally, the 433VM/MM variant genotypes were associated with lower urinary levels of 20-HETE compared with 433VV (3.14 (0.86) vs. 8.45 (3.69) ng/mg Creatinine, p = 0.024). Our results indicate that the CYP4F2 V433M polymorphism, by decreasing 20-HETE levels, may play an important role in DKD. Full article
(This article belongs to the Special Issue Update on Diabetic Nephropathy: Recent Progress and Future Perspective)

Review

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19 pages, 1347 KiB  
Review
Therapeutic Advances in Diabetic Nephropathy
by Hanny Sawaf, George Thomas, Jonathan J. Taliercio, Georges Nakhoul, Tushar J. Vachharajani and Ali Mehdi
J. Clin. Med. 2022, 11(2), 378; https://doi.org/10.3390/jcm11020378 - 13 Jan 2022
Cited by 70 | Viewed by 18518
Abstract
Diabetic kidney disease (DKD) is the most common cause of end-stage kidney disease (ESKD) in the United States. Risk factor modification, such as tight control of blood glucose, management of hypertension and hyperlipidemia, and the use of renin–angiotensin–aldosterone system (RAAS) blockade have been [...] Read more.
Diabetic kidney disease (DKD) is the most common cause of end-stage kidney disease (ESKD) in the United States. Risk factor modification, such as tight control of blood glucose, management of hypertension and hyperlipidemia, and the use of renin–angiotensin–aldosterone system (RAAS) blockade have been proven to help delay the progression of DKD. In recent years, new therapeutics including sodium-glucose transport protein 2 (SGLT2) inhibitors, endothelin antagonists, glucagon like peptide-1 (GLP-1) agonists, and mineralocorticoid receptor antagonists (MRA), have provided additional treatment options for patients with DKD. This review discusses the various treatment options available to treat patients with diabetic kidney disease. Full article
(This article belongs to the Special Issue Update on Diabetic Nephropathy: Recent Progress and Future Perspective)
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