Linking Metabolism and Immunology: Diabetic Nephropathy Is an Inflammatory Disease

[摘要] Diabetic nephropathy is one of the most important concerns in nephrology, as well as in medicine at large. Rapidly increasing rates of diabetes throughout the developed world represent an emerging epidemic with profound consequences. This epidemic is likely to drive previously unforeseen rates of vascular target organ complications. As survival from acute cardiovascular complications continues to improve, management of chronic complications such as kidney disease assume ever-larger roles. Diabetes is the leading cause of end-stage renal disease in the United States, accounting for approximately 45% of incident cases and 55% of prevalent cases in the present decade (1,2). End-stage renal disease in diabetes, particularly type 2, has been described as a medical catastrophe of worldwide dimensions (3). So what can be done to reduce the burden of diabetic nephropathy? Available therapies shown to prevent or slow progression should be broadly applied. These therapies include strict glycemic control and treatment of hypertension with inhibitors of the renin-angiotensin system (4–10). However, in recent clinical trials in which care was presumably optimized, renoprotecion was far from complete. And, in reality, controlling hyperglycemia and hypertension in usual care settings is often more challenging than in clinical trials. Hence, even more effective therapies that interrupt mechanisms of kidney damage induced by hyperglycemia and/or hypertension are urgently needed.

[学科分类] 泌尿医学

[关键词] Bone marrow necrosis;Sickle cell disease;Hyperhemolysis syndrome