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Cited by 259

The DOI matches its Crossref record; 665 of the 665 references it cites were found in a registry or an index.

Pathophysiology of the Diabetic Kidney

Open access
Vallon, Volker, Komers, Radko·2011·Comprehensive Physiology
DOI 10.1002/cphy.c100049
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Abstract

Diabetes mellitus contributes greatly to morbidity, mortality, and overall health care costs. In major part, these outcomes derive from the high incidence of progressive kidney dysfunction in patients with diabetes making diabetic nephropathy a leading cause of end‐stage renal disease. A better understanding of the molecular mechanism involved and of the early dysfunctions observed in the diabetic kidney may permit the development of new strategies to prevent diabetic nephropathy. Here we review the pathophysiological changes that occur in the kidney in response to hyperglycemia, including the cellular responses to high glucose and the responses in vascular, glomerular, podocyte, and tubular function. The molecular basis, characteristics, and consequences of the unique growth phenotypes observed in the diabetic kidney, including glomerular structures and tubular segments, are outlined. We delineate mechanisms of early diabetic glomerular hyperfiltration including primary vascular events as well as the primary role of tubular growth, hyperreabsorption, and tubuloglomerular communication as part of a “tubulocentric” concept of early diabetic kidney function. The latter also explains the “salt paradox” of the early diabetic kidney, that is, a unique and inverse relationship between glomerular filtration rate and dietary salt intake. The mechanisms and consequences of the intrarenal activation of the renin‐angiotensin system and of diabetes‐induced tubular glycogen accumulation are discussed. Moreover, we aim to link the changes that occur early in the diabetic kidney including the growth phenotype, oxidative stress, hypoxia, and formation of advanced glycation end products to mechanisms involved in progressive kidney disease. © 2011 American Physiological Society.Compr Physiol 1:1175‐1232, 2011.

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Metadata

Authors
Vallon, V., & Komers, R.
Venue
Comprehensive Physiology
Publisher
Wiley
Published
2011-07
Volume
1
Issue
3
Pages
1175-1232
ISSN
2040-4603 (ISSN-L)
DOI
10.1002/cphy.c100049
OpenAlex
W1540594287
Cited by
259
References
665
Type
other
Language
en
Open access
green

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