Kopel J, Pena-Hernandez C, Nugent K. Evolving spectrum of diabetic nephropathy. World J Diabetes 2019; 10(5): 269-279 [PMID: 31139314 DOI: 10.4239/wjd.v10.i5.269]
Corresponding Author of This Article
Jonathan Kopel, BSc, Research Scientist, MD-PhD Student, Cell Biology and Biochemistry, Texas Tech University Health Sciences Center, 3601 4th St, Lubbock, TX 79416, United States. jonathan.kopel@ttuhsc.edu
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Diabetes. May 15, 2019; 10(5): 269-279 Published online May 15, 2019. doi: 10.4239/wjd.v10.i5.269
Evolving spectrum of diabetic nephropathy
Jonathan Kopel, Camilo Pena-Hernandez, Kenneth Nugent
Jonathan Kopel, Cell Biology and Biochemistry, Texas Tech University Health Sciences Center, Lubbock, TX 79416, United States
Camilo Pena-Hernandez, Department of Internal Medicine, Division of Nephrology, Lubbock, TX 79430, United States
Kenneth Nugent, Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, United States
Author contributions: Kopel J and Nugent K were the primary authors involved with the conception, drafting the article, and interpretation of the review. Pena-Hernandez C was involved in the critical revision of the article.
Conflict-of-interest statement: The authors whose names are listed immediately below certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Jonathan Kopel, BSc, Research Scientist, MD-PhD Student, Cell Biology and Biochemistry, Texas Tech University Health Sciences Center, 3601 4th St, Lubbock, TX 79416, United States. jonathan.kopel@ttuhsc.edu
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Received: March 18, 2019 Peer-review started: March 19, 2019 First decision: May 8, 2019 Revised: May 13, 2019 Accepted: May 13, 2019 Article in press: May 14, 2019 Published online: May 15, 2019
Abstract
Diabetes remains an important health issue as more patients with chronic and uncontrolled diabetes develop diabetic nephropathy (DN), which classically presents with proteinuria followed by a progressive decrease in renal function. However, an increasing proportion of DN patients have a decline in kidney function and vascular complications without proteinuria, known as non-proteinuric DN (NP-DN). Despite the increased incidence of NP-DN, few clinical or experimental studies have thoroughly investigated the pathophysiological mechanisms and targeted treatment for this form of DN. In this review, we will examine the differences between conventional DN and NP-DN and consider potential pathophysiological mechanisms, diagnostic markers, and treatment for both DN and NP-DN. The investigation of the pathophysiology of NP-DN should provide additional insight into the cardiovascular factors influencing renal function and disease and provide novel treatments for the vascular complications seen in diabetic patients.
Core tip: Diabetes remains an important health issue as more patients with chronic and uncontrolled diabetes develop diabetic nephropathy (DN). In recent years, an increasing proportion of DN patients have a decline in kidney function and vascular complications without proteinuria, known as non-proteinuric DN (NP-DN). This manuscript advances this discussion by examining the potential pathophysiological mechanisms, diagnostic markers, and treatments relevant to NP-DN. Furthermore, it illustrates the significance of renal microhemodynamics in the development of NP-DN.
