Diabetes and Kidney Disease

Description

This book provides a concise yet comprehensive resource on Diabetic Kidney Disease. Similar to the previous edition, the book reviews the most up-to-date research on diabetic nephropathy, the current understanding of its pathophysiology, renal structural alterations and clinical features, and summarizes recent evidence-based clinical treatment modalities for the prevention and management of diabetic kidney disease. General clinical aspects are also covered, as well as an overview to the novel approaches being designed by leading researchers in the field. A convenient compendium for physicians involved in the care of diabetic patients with varying degrees of kidney involvement, Diabetes and Kidney Disease, 2e is also a handy resource for medical residents and students interested in the current status and future approaches to reducing the burden of diabetes and diabetic kidney disease. Contents Contributors Chapter 1: Historical Background of Diabetic Kidney Disease Introduction The Discovery of Diabetic Kidney Disease The Pathology of Diabetic Renal Disease Initial Studies of Renal Biopsies Radioimmunoassay and the Concept of Microalbuminuria The Renin–Angiotensin–Aldosterone System and Diabetic Kidney Disease Value of Glycemic Control Treatment of Hyperglycemia Intensive Glycemic Control The Impact of Glucose-Lowering Drugs on Diabetic Kidney Disease Progression Sodium Glucose Transporter Inhibitors (SGLT2i) Glucagon-like Peptide-1 Receptor (GLP-1R) Agonists Bardoxolone Recent Updates Conclusion References Chapter 2: Diabetes and Kidney Disease: A Review of the Clinical Practice Guidelines Introduction Glycemic Management Glycemic Monitoring and Targets Medical Therapy for Hyperglycemia Older Agents Newer Agents Sodium-Glucose Cotransporter 2 Inhibitors (SGLT2i) Glucagon-Like Peptide-1 Receptor Agonists (GLP-1RA) Insulin Use in Type 2 DM Hypertension Control in DKD Hypertension Management Albuminuria Management Lifestyle Management Tobacco Cessation Dietary Modifications Physical Activity and Exercise Self-management Programs and Team-Based Care References Part I: Natural Course, Pathogenesis, Morphology and Genetics Chapter 3: Diabetic Kidney Disease: Scope of the Problem Epidemiology of Diabetic Kidney Disease Obesity, Metabolic Syndrome, and Diabetic Nephropathy Geriatrics and Diabetic Nephropathy References Chapter 4: Natural Course (Stages/Evidence-Based Discussion) Introduction Natural History of DKD in T1DM Stage 1: Hypertrophy-Hyperfiltration Stage 2: The Silent Stage Stage 3: Microalbuminuria or Incipient Diabetic Nephropathy (IDN) Stage 4: Macroalbuminuria Stage 5: Uremia Natural History of Diabetic Kidney Disease in T2DM Stage 1: Initial Stage in T2DM Stage 2: Normoalbuminuria Stage 3: Microalbuminuria or Incipient Diabetic Nephropathy Stage 4: ODN Stage 5: ESRD Non-albuminuric DKD References Chapter 5: Pathogenesis: Hemodynamic Alterations Introduction Single Nephron GFR Versus Total GFR Renin-Angiotensin-Aldosterone System Angiotensinogen ACE-Ang II-AT-1R Axis ACE2-Ang (1–7)-Mas Axis Ang (1–9) Renin/Prorenin Aldosterone Neprilysin Prolyl Oligopeptidase How Hyperglycemia Affects Single Nephron GFR Hemodynamics as an Upstream Pathomechanism in Diabetic Nephropathy References Chapter 6: Pathogenesis: Structural Changes in the Kidneys in Type 1 and Type 2 Diabetes Introduction A Bit of History Morphologic Findings in Diabetic Nephropathy and Related Physiopathology Comparison of Diabetic Nephropathy in Type 1 and 2 Diabetic Patients Pathologic Classification of Diabetic Nephropathy Understanding the Pathology in Diabetic Kidney Disease: From the Research Laboratory to the Evaluation of Kidney Samples Reversibility of Structural and Functional Damage in Advanced Diabetic Kidney Disease Microalbuminuria: The Gold Standard for Diagnosis of Diabetic Kidney Disease Other Urinary Biomarkers of Diabetic Kidney Disease Other Biomarkers of Diabetic Kidney Disease Under Study Differential Diagnosis of Diabetic Kidney Disease Superimposed Pathology (Nondiabetic Lesions) That Can Alter Structural Alterations in Diabetic Nephropathy Cases Conclusions References Chapter 7: Diabetes in Children and Adolescents Introduction Epidemiology of DM Etiology of DM Pathophysiology of DM Development of the Pancreas Developmental Programming of DM Clinical Manifestations of DM Acute Complications of DM Diagnosis Monogenic DM Genetic Defects of β-Cell Function Other Causes of Familial DM Treatment of DM Treatment of T1DM Insulin Insulin Regimens Monitoring Treatment of T2DM Treatment of DKA and HHS Treatment of Monogenic DM Chronic Complications and Comorbidities of DM Diabetic Kidney Disease Diabetic Kidney Disease Hyperfiltration Inflammation ESRD Screening and Prevention of DM Transition of Adolescents with DM to Adult Healthcare Service References Part II: Clinical Presentation and Associated Conditions Chapter 8: Screening, Early Diagnosis, Genetic Markers and Predictors of Progression Introduction Screening Albuminuria Glomerular Filtration Rate Diagnosis Other Clinical Predictors of Diabetic Kidney Disease Age Hypertension Hyperglycemia Diabetic Retinopathy Novel Biomarkers Proteomics Genetic Markers Conclusion References Chapter 9: Atypical Presentations Overview of Traditional and Nontraditional Concepts in Diabetic Kidney Disease Hyperfiltration and Increased GFR Herald the Onset of Diabetic Kidney Disease The Roles of Glucotoxicity, Oxidative Stress (OS), and Inflammation in Diabetic Kidney Disease AGEs, Oxidative Stress and the Impact on the Diabetic Kidney Endogenous AGEs Exogenous AGEs Role of Polyclonal Free Light Chains (pcFLCs) in Diabetic Nephropathy Antioxidants and Inhibition of Inflammation Treatment with RAAS Inhibitors Aldosterone Blockade and Protection Against Diabetic Nephropathy Allopurinol Conclusion References Chapter 10: Albuminuria and Proteinuria Definitions of Proteinuric States in Diabetic Kidney Disease Justification of the Term “Albuminuria-Proteinuria” Measurement of Urinary Albumin Significance of Albuminuria in Type 1 Diabetic Patients Significance of Albuminuria in Type 2 Diabetic Patients Mechanisms of Albuminuria in Diabetes Extrarenal Manifestations of Albuminuria Albuminuria and Cardiovascular Disease Albuminuria and Hypertension Determinants of Albuminuria Screening for Albuminuria Proteinuria of Nondiabetic Origin Treatment of Albuminuria-Proteinuria Podocyte-Specific Drugs Conclusions References Chapter 11: Hypertension and Diabetes Introduction Pathophysiology of Hypertension in Diabetics Hypertension and Type 1 Diabetes Mellitus Hypertension and Type 2 Diabetes Cardiovascular Outcomes in Hypertensive Diabetics vs. Hypertensive Non-Diabetics Renal Outcomes in Hypertensive Diabetics Hypertension Treatment Strategies in Diabetics Lifestyle Modifications Effects of Antihypertensive Drugs on Incident Diabetes Pharmacological Treatment of Hypertension in Diabetes Overview ARBs ACE-Inhibitors Renin Inhibitor(s) Calcium Antagonists Beta-Blockers Diuretics Other Drug Classes Blood Pressure Treatment Targets for All Diabetics? References Chapter 12: Obesity and Metabolic Syndrome The Role of Visceral Adiposity Renal Alterations in Obesity Increased Sympathetic Nervous System Activity The Role of Adipose Tissue and Kidney Disease Metabolic Syndrome Quantification of Adipose Tissue in Chronic Kidney Disease Treatment Lifestyle Modifications Drug Therapy Bariatric Surgery Management Obesity in Patients with ESKD Conclusion References Chapter 13: Anemia and Diabetes Definition and Prevalence of Anemia in CKD Causes of Anemia Iron Deficiency Erythropoietin Deficiency and Hypo Responsiveness Nephrotic Syndrome ACE Inhibitors and Angiotensin Receptor Antagonists Consequences of Anemia Quality of Life Progression of Kidney Disease Cardiovascular Disease Clinical Trials of Erythropoietin-Stimulating Agents Kidney Outcomes Cardiovascular Outcomes Cardiovascular Events Clinical Practice Guidelines for Evaluation of Anemia Recommendations for Treatment of Anemia KDIGO and NKF Clinical Practice Guidelines Food and Drug Administration Anemia Management Monitoring Response to Treatment Adverse Side Effects of Therapy Economic Burden of Anemia Areas of Uncertainty Hypoxia Inducible Factor-Prolyl Hydroxylase Inhibitor (HIF-PHI): A New Beginning? Summary References Chapter 14: Cardiovascular Disease and Diabetic Kidney Disease Cardiovascular Disease in Patients with Diabetes Heart Failure and Type 2 Diabetes Cardiovascular Disease in Chronic Kidney Disease Cardiovascular Disease and Diabetic Kidney Disease Sodium-Glucose Cotransporter-2 Inhibitors Conclusion References Chapter 15: Dyslipidemia and Diabetes Introduction DKD: Definition and Diagnosis Lipid Disturbances in Diabetes, CKD, and DKD Management of CKD Guidelines Conclusions References Chapter 16: Bone Disease and Diabetes Introduction Epidemiology: Fracture Risk Bone Density in Diabetes Underlying Mechanisms of Bone Fragility Insulin AGEs Vitamin D and Calcium Bone Microarchitecture Sarcopenia HbA1c Adiposity-Related Factors Therapy Diabetic Kidney Disease Assessment Treatment References Chapter 17: Diabetic Retinopathy Hyperglycemia Hypertension Hyperlipidemia Pregnancy Kidney Disease Other Risk Factors Classification of Diabetic Retinopathy Non-proliferative Diabetic Retinopathy Diabetic Macular Edema Proliferative Diabetic Retinopathy Screening for Diabetic Retinopathy Treatment of Diabetic Retinopathy Other Ocular Manifestations References Chapter 18: Pregnancy and Diabetes Introduction Maternal Pregnancy Outcomes Fetal Pregnancy Outcomes Gestational Diabetes Mellitus Treatment of Diabetes and CKD from Diabetic Kidney Disease During Pregnancy Preeclampsia Prevention Antihyperglycemic Treatment Hypertension Treatment Anemia of Chronic Kidney Disease Mineral Bone Disease of CKD Postpartum Treatment Preconception Counseling Special Considerations: Kidney Biopsy During Pregnancy Conclusion References Chapter 19: Kidney Transplantation and Kidney Pancreas Transplantation Introduction Transplant Options for Patients with Diabetic Kidney Disease Patient Selection and Kidney Transplant Pancreas Transplantation Indications for Pancreas Transplants Pancreatic Islet Cell Transplantation Posttransplant Diabetes Mellitus (PTDM) Summary and Conclusions References Chapter 20: Diabetic Kidney Disease and Covid-19 Introduction Diabetic Kidney Disease and SARS-CoV-2: An Immunological Approach Diabetic Kidney Disease and SARS-CoV-2: A Therapeutics Approach Metformin and DPP-4 Inhibitors Sodium-Glucose co-Transporter-2 (SGLT2) Inhibitors Glucagon-like Peptide 1 Receptor Agonists (GLP-1RAs) Statins and Vitamin D: Common Drugs Used in Diabetic Patients Conclusions References Part III: Treatment and Prognosis Chapter 21: Glycemic Control Introduction Assessment Estimation of Kidney Function and Staging of Diabetic Kidney Disease Glycemic Target UKPDS, DCCT, and Kumamoto ACCORD, ADVANCE, and VADT Management Non-insulin Medications Oral Biguanides Sulfonylureas Meglitinides Thiazolidinediones Dipeptidyl Peptidase-4 Inhibitors Alpha-Glucosidase Inhibitors Sodium-Glucose Co-transporter-2 Inhibitors Parenteral Glucagon-Like Peptide 1 Receptor Agonists Amylin Analogues Others Dopamine Agonists Bile Acid Sequestrants Insulin Recommendation for Type 2 Diabetes Management in Chronic Kidney Disease Recommendation for Management of Diabetic Ketoacidosis in End-Stage Kidney Disease Monitoring Measuring Glycemic Control Hypoglycemia References Chapter 22: Computerized Clinical Decision Support Scope of the Problem Epidemiology Early Recognition Proven Interventions Under-Recognition of CKD Under-Treatment of CKD Introduction to CDS Clinically Relevant CDS Future Directions with CDS Existing CDS Systems for Diabetes, Hypertension, and CKD Preventing Adverse Drug Events in CKD CDS to Prompt Recognition of CKD CDS Systems to Improve Blood Pressure Control CDS Systems to Improve Diabetes Management CDS to Treat CKD Optimal CDS for Diabetes and CKD Identifying High-Risk Patients Preventing Drug Adverse Events Identifying Patients Not Meeting Treatment Goals Recommendations to Help Providers Reach Treatment Goals Engaging Patients Ensuring Success Monitoring Outcomes References Chapter 23: Antihypertensive Therapies Introduction Interventions for Early Diabetic Kidney Disease Glycemic Control Inhibitors of the Renin-Angiotensin System Angiotensin-Converting Enzyme Inhibitors Angiotensin II Receptor Blockers Direct Renin Inhibitor(s) Aldosterone Antagonists Other Combinations of RAS Blockers Blood Pressure Lowering Dietary Protein Restriction Dietary Sodium Restriction Sodium-Glucose Linked Transporter-2 (SGLT-2) Inhibitors Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists Summary References Chapter 24: Diabetes and Kidney disease: metformin Metformin: Mechanisms of Action (Fig. 24.1) Metformin-Positive Effects in the Diabetic Kidney Experimental Work Clinical Studies Metformin and Lactic Acidosis in Patients with Diabetes: The Role of Kidney Function Guidelines on the Use of Metformin in Patients with Kidney Disease (Fig. 24.2) Conclusions References Chapter 25: Sodium-Glucose Cotransporter-2 (SGLT2) Inhibitors Introduction Basic Pharmacology of SGLT2i Cardiorenal Benefits of SGLT2i in Patients with Type 2 Diabetes Adverse Effects Urogenital Infections Diabetic Ketoacidosis (DKA) Acute Kidney Injury (AKI) and Volume Depletion Amputations Use in Kidney Transplant Recipients Approved Uses and Pharmacological Properties of Individual SGLT2i Practical Considerations References Chapter 26: Glucagon-like Peptide-1 Receptor Agonists (GLP1-RA) Introduction Glucagon-like Peptide-1 Physiology and Natural Functions Natural Roles of GLP-1 Glucose Homeostasis Immunity Currently Available GLP-1 Receptor Agonist Therapies Kidney Disease Outcome Data Lixisenatide Liraglutide Semaglutide Dulaglutide Exenatide Putative Mechanisms of Kidney Protection by GLP-1 Receptor Agonists Guideline Recommendations on GLP-1 Receptor Agonist Use in DKD Conclusion References Chapter 27: Dipeptidyl Peptidase-4 (DPP4) Inhibitors Introduction Mechanism of Action DPP-4 Enzyme Antiglycemic Effects of DPP-4 Inhibitors (DPP-4i) Potential Effects of DPP-4i on the Mechanisms of Diabetic Kidney Disease Benefits of DPP-4i in Patients with Type 2 Diabetes Mellitus Adverse Events (AEs) Pancreatitis Hospitalization for Heart Failure (hHF) Arthralgias Application of DPP-4i in Special Populations Kidney Transplant Recipients Dialysis Practice Considerations References Chapter 28: Novel Treatments and the Future of DKD: What Is on the Horizon? Introduction The Role of Immune System and Prospects of Immunotherapy in Type 1 Diabetes The Immune System and Type 2 Diabetes Epithelial-to-Mesenchymal Transition and Kidney Fibrosis: Potential for Reversibility The Promise of Metabolomics and Proteomics Genes, Epigenetics, and MicroRNAs Nanotechnology in Diabetes Research and Treatment In Pursuit of Futuristic Therapies Concluding Remarks References Chapter 29: Putting it All Together: Practical Approach to the Patient with Diabetic Kidney Disease Scope of the Problem Risk Factors for Development of Type 2 Diabetes Population Considerations Additional Risk Factors Screening for Diabetes Screening for and Diagnosis of Diabetic Kidney Disease Management Lifestyle Management Cardiovascular and Renal Protection RAAS (Renin-Angiotensin-Aldosterone System) Inhibition Angiotensin 2 Inhibition Mineralocorticoid Inhibition SGLT2 Inhibitors Newer Therapies GLP-1RA Selective Mineralocorticoid Receptor Antagonists Glycemic Control Monitoring Choice of Agents Metformin Hypertension Control Cholesterol Management Resources Summary References Index