Predictors of Kidney Disease in Diabetic, Hypertensive Patients View Full Text


Ontology type: schema:Chapter     


Chapter Info

DATE

2012-09-18

AUTHORS

Jaya P. Buddineni , Kunal Chaudhary , Adam Whaley-Connell

ABSTRACT

The underlying mechanisms of insulin resistance that contribute to the development of overt type 2 diabetes mellitus also contribute to endothelial dysfunction and hypertension that are related to chronic kidney disease (CKD). The hyperinsulinemic state is associated with inappropriate activation of the renin–angiotensin–aldosterone system (RAAS) and sympathetic nervous system that leads to sodium and extracellular fluid expansion as well as increased tissue inflammation and oxidative stress. Moreover, mounting evidence in recent years supports that insulin resistance is independently associated with proteinuria and the development of CKD. Elevations in circulating insulin and impairments in insulin-dependent metabolic signaling pathways are associated with upregulation of angiotensinogen expression contributing to the maladaptive effects of angiotensin II and aldosterone on the kidneys. Thereby, aggressive management of risk factors, using both pharmacologic and non-pharmacological strategies, is essential to diminish loss of kidney function. Thereby we will review the mechanisms leading to kidney disease in insulin-resistant individuals. More... »

PAGES

107-119

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/978-1-60327-357-2_9

DOI

http://dx.doi.org/10.1007/978-1-60327-357-2_9

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1024037946


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