To the Editor:Diabetic kidney disease (DKD)is the most common cause of end-stage renal disease (ESRD);however,the onset of DKD is difficult to detect.[1]When persistent microalbuminuria becomes detectable,DKD has alre...To the Editor:Diabetic kidney disease (DKD)is the most common cause of end-stage renal disease (ESRD);however,the onset of DKD is difficult to detect.[1]When persistent microalbuminuria becomes detectable,DKD has already progressed to the third disease stage,and finding biomarkers that are more sensitive than microalbuminuria is therefore necessary to indicate kidney damage at an earlier stage of DKD.[2]Both glomerular and tubulointerstitial damages have been repeatedly demonstrated to be important factors in the pathophysiology of DKD.[3] Therefore,we investigated the expression levels of six markers closely related to the glomerulus and renal tubule.展开更多
Diabetic kidney disease （DKD） is one of the primary causes of end-stage renal disease （ESRD）. Early diagnosis is very important in preventing the development of DKD. Urinary albumin excretion rate （UAER） and glo...Diabetic kidney disease （DKD） is one of the primary causes of end-stage renal disease （ESRD）. Early diagnosis is very important in preventing the development of DKD. Urinary albumin excretion rate （UAER） and glomerular filtration rate （GFR） are widely accepted as criteria for the diagnosis and clinical grading of DKD, and microalbuminuria has been recommended as the first clinical sign of DKD. The natural history of DKD has been divided into three stages： normoalbuminuria, microalbuminuria, and macroalbuminuria. However, this clinical paradigm has been questioned recently, as studies have shown that a portion of diabetes mellitus （DM） patients with normoalbuminuria have progressive renal insufficiency, referred to as normoalbuminuric diabetic kidney disease （NADKD） or nonalbuminuric diabetic nephropathy. Epidemiologic research has demonstrated that normoalbuminuric diabetic kidney disease is common, and the large number of NADKD patients suggests that the traditional paradigm needs to be shifted. Currently, the pathogenesis of NADKD remains unclear, but many clinical studies have identified some clinical and pathological features of NADKD. In addition, the long-term outcomes of NADKD patients remain controversial. In this article, we reviewed the latest studies addressing the pathogenesis, pathology, treatment and prevention of NADKD.展开更多
基金the grants from the National Key R&D Program of China (No.2016YFC1305500and No.2016YFC 1305404)the National Natural Science Foundation of China (No.61471399,No.61671479,and No.81670663)+1 种基金the Joint Funds of National Natural Science Foundation of China and Henan Province (No.U1604284) the Special Research Project on Health Care of the Chinese People's Liberation Army (No.15BJZ35).
文摘To the Editor:Diabetic kidney disease (DKD)is the most common cause of end-stage renal disease (ESRD);however,the onset of DKD is difficult to detect.[1]When persistent microalbuminuria becomes detectable,DKD has already progressed to the third disease stage,and finding biomarkers that are more sensitive than microalbuminuria is therefore necessary to indicate kidney damage at an earlier stage of DKD.[2]Both glomerular and tubulointerstitial damages have been repeatedly demonstrated to be important factors in the pathophysiology of DKD.[3] Therefore,we investigated the expression levels of six markers closely related to the glomerulus and renal tubule.
文摘Diabetic kidney disease （DKD） is one of the primary causes of end-stage renal disease （ESRD）. Early diagnosis is very important in preventing the development of DKD. Urinary albumin excretion rate （UAER） and glomerular filtration rate （GFR） are widely accepted as criteria for the diagnosis and clinical grading of DKD, and microalbuminuria has been recommended as the first clinical sign of DKD. The natural history of DKD has been divided into three stages： normoalbuminuria, microalbuminuria, and macroalbuminuria. However, this clinical paradigm has been questioned recently, as studies have shown that a portion of diabetes mellitus （DM） patients with normoalbuminuria have progressive renal insufficiency, referred to as normoalbuminuric diabetic kidney disease （NADKD） or nonalbuminuric diabetic nephropathy. Epidemiologic research has demonstrated that normoalbuminuric diabetic kidney disease is common, and the large number of NADKD patients suggests that the traditional paradigm needs to be shifted. Currently, the pathogenesis of NADKD remains unclear, but many clinical studies have identified some clinical and pathological features of NADKD. In addition, the long-term outcomes of NADKD patients remain controversial. In this article, we reviewed the latest studies addressing the pathogenesis, pathology, treatment and prevention of NADKD.
