TY - JOUR
T1 - Diabetic kidney disease
AU - Thomas, Merlin C.
AU - Brownlee, Michael
AU - Susztak, Katalin
AU - Sharma, Kumar
AU - Jandeleit-Dahm, Karin A.M.
AU - Zoungas, Sophia
AU - Rossing, Peter
AU - Groop, Per Henrik
AU - Cooper, Mark E.
N1 - Funding Information:
K. Susztak has received research support from Boehringer Ingelheim and Biogen Idec for projects not related to this publication, and is on the advisory board of AbbVie. She has received research support from the US National Institutes of Health (NIH), the Juvenile Diabetes Research Foundation (JDRF) and the American Diabetes Association (ADA). K. Sharma has received research support from AbbVie, Boehringer Ingelheim and Stealth Peptides for projects not related to this publication, and is on the scientific advisory board of Merck and Astellas. He is founder of Clinical Metabolomics, and has received research support from the NIH, the JDRF and the ADA. K.A.M.J.D. has received research grants from Genkyotex and Boehringer Ingelheim. S.Z. has served on the advisory board for Amgen, AstraZeneca, Bristol-Myers Squibb, Merck Sharp & Dohme, Novartis, Sanofi and Takeda Pharmaceuticals. S.Z. has received consultancy fees and honoraria from AstraZeneca, Bristol-Myers Squibb, Janssen-Cilag, Merck Sharp & Dohme and Servier Laboratories. She has received grants from the National Health and Medical Research Council and the Heart Foundation of Australia, and has undertaken institutional contract work for Bristol-Myers Squibb and the Commonwealth Department of Health.
Funding Information:
M.C.T. has received honoraria for educational meetings conducted on behalf of AbbVie, Boehringer Ingelheim, Eli Lilly and Company, Merck Sharpe & Dohme, Servier, Novartis, Takeda, Abbott, Allergan and AstraZeneca. M.B. declares no competing interests. K. Susztak has received research support from Boehringer Ingelheim and Biogen Idec for projects not related to this publication, and is on the advisory board of AbbVie. She has received research support from the US National Institutes of Health (NIH), the Juvenile Diabetes Research Foundation (JDRF) and the American Diabetes Association (ADA). K. Sharma has received research support from AbbVie, Boehringer Ingelheim and Stealth Peptides for projects not related to this publication, and is on the scientific advisory board of Merck and Astellas. He is founder of Clinical Metabolomics, and has received research support from the NIH, the JDRF and the ADA. K.A.M.J-.D. has received research grants from Genkyotex and Boehringer Ingelheim. S.Z. has served on the advisory board for Amgen, AstraZeneca, Bristol-Myers Squibb, Merck Sharp & Dohme, Novartis, Sanofi and Takeda Pharmaceuticals. S.Z. has received consultancy fees and honoraria from AstraZeneca, Bristol-Myers Squibb, Janssen-Cilag, Merck Sharp & Dohme and Servier Laboratories. She has received grants from the National Health and Medical Research Council and the Heart Foundation of Australia, and has undertaken institutional contract work for Bristol-Myers Squibb and the Commonwealth Department of Health. P.R. has received consultancy and/or speaking fees (to his institution) from AstraZeneca, Bristol-Myers Squibb, Boehringer Ingelheim, Eli Lilly and Company, Novo Nordisk, Sanofi Aventis, Astellas, AbbVie and Merck Sharp & Dohme. He has received research grants from AbbVie, Novo Nordisk and Astra Zeneca. P.R. has shares in Novo Nordisk. P-.H.G. has received lecture honoraria from Boehringer Ingelheim, AstraZeneca, Genzyme, Novartis, Novo Nordisk, Merck Sharp & Dohme, Eli Lilly and Company and Medscape. M.E.C. has received honoraria and consulting fees from AbbVie, Bayer, Boehringer Ingelheim, Eli Lilly and Company, Merck Sharpe and Dohme, Servier, Takeda, Novo Nordisk and AstraZeneca, as well as research grants from Novo Nordisk and AbbVie.
Publisher Copyright:
© 2015 Macmillan Publisher Limited. All rights reserved.
PY - 2015/7/30
Y1 - 2015/7/30
N2 - The kidney is arguably the most important target of microvascular damage in diabetes. A substantial proportion of individuals with diabetes will develop kidney disease owing to their disease and/or other co-morbidity, including hypertension and ageing-related nephron loss. The presence and severity of chronic kidney disease (CKD) identify individuals who are at increased risk of adverse health outcomes and premature mortality. Consequently, preventing and managing CKD in patients with diabetes is now a key aim of their overall management. Intensive management of patients with diabetes includes controlling blood glucose levels and blood pressure as well as blockade of the renin-angiotensin-aldosterone system; these approaches will reduce the incidence of diabetic kidney disease and slow its progression. Indeed, the major decline in the incidence of diabetic kidney disease (DKD) over the past 30 years and improved patient prognosis are largely attributable to improved diabetes care. However, there remains an unmet need for innovative treatment strategies to prevent, arrest, treat and reverse DKD. In this Primer, we summarize what is now known about the molecular pathogenesis of CKD in patients with diabetes and the key pathways and targets implicated in its progression. In addition, we discuss the current evidence for the prevention and management of DKD as well as the many controversies. Finally, we explore the opportunities to develop new interventions through urgently needed investment in dedicated and focused research. For an illustrated summary of this Primer, visit: http://go.nature.com/NKHDzg.
AB - The kidney is arguably the most important target of microvascular damage in diabetes. A substantial proportion of individuals with diabetes will develop kidney disease owing to their disease and/or other co-morbidity, including hypertension and ageing-related nephron loss. The presence and severity of chronic kidney disease (CKD) identify individuals who are at increased risk of adverse health outcomes and premature mortality. Consequently, preventing and managing CKD in patients with diabetes is now a key aim of their overall management. Intensive management of patients with diabetes includes controlling blood glucose levels and blood pressure as well as blockade of the renin-angiotensin-aldosterone system; these approaches will reduce the incidence of diabetic kidney disease and slow its progression. Indeed, the major decline in the incidence of diabetic kidney disease (DKD) over the past 30 years and improved patient prognosis are largely attributable to improved diabetes care. However, there remains an unmet need for innovative treatment strategies to prevent, arrest, treat and reverse DKD. In this Primer, we summarize what is now known about the molecular pathogenesis of CKD in patients with diabetes and the key pathways and targets implicated in its progression. In addition, we discuss the current evidence for the prevention and management of DKD as well as the many controversies. Finally, we explore the opportunities to develop new interventions through urgently needed investment in dedicated and focused research. For an illustrated summary of this Primer, visit: http://go.nature.com/NKHDzg.
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U2 - 10.1038/nrdp.2015.18
DO - 10.1038/nrdp.2015.18
M3 - Review article
AN - SCOPUS:85017272654
VL - 1
JO - Nature Reviews Disease Primers
JF - Nature Reviews Disease Primers
SN - 2056-676X
M1 - 15018
ER -