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SGLT2 Inhibitors: Emerging Roles in the Protection Against Cardiovascular and Kidney Disease Among Diabetic Patients.
Conclusion: SGLT2 inhibitors are novel antidiabetic medications with immense utility in the management of patients with T2DM. Furthermore, SGLT2 inhibitors have demonstrated to reduce the progression to advanced forms of kidney disease and its associated complications. These medications should be front and center in the management of patients with diabetic kidney disease with and without chronic kidney disease as they confer protection against cardiovascular/renal death and improve all-cause mortality. Future studies should evaluate the benefits and implications of early initiation of SGLT2 inhibitors, as well as the long-...
Source: International Journal of Nephrology and Renovascular Disease - November 7, 2020 Category: Urology & Nephrology Tags: Int J Nephrol Renovasc Dis Source Type: research

PPARγ is a gatekeeper for extracellular matrix and vascular cell homeostasis: beneficial role in pulmonary hypertension and renal/cardiac/pulmonary fibrosis
Purpose of review Pulmonary arterial hypertension (PAH) is characterized by pulmonary arterial endothelial cell (PAEC) dysfunction and apoptosis, pulmonary arterial smooth muscle cell (PASMC) proliferation, inflammation, vasoconstriction, and metabolic disturbances that include disrupted bone morphogenetic protein receptor (BMPR2)-peroxisome proliferator-activated receptor gamma (PPARγ) axis and DNA damage. Activation of PPARγ improves many of these mechanisms, although erroneous reports on potential adverse effects of thiazolidinedione (TZD)-class PPARγ agonists reduced their clinical use in the past decade. Here, we...
Source: Current Opinion in Nephrology and Hypertension - January 30, 2020 Category: Urology & Nephrology Tags: PATHOPHYSIOLOGY OF HYPERTENSION: Edited by Nancy J. Brown Source Type: research

Extrarenal manifestations of the hemolytic uremic syndrome associated with Shiga toxin-producing Escherichia coli (STEC HUS)
AbstractHemolytic uremic syndrome is commonly caused by Shiga toxin-producingEscherichia coli (STEC). Up to 15% of individuals with STEC-associated hemorrhagic diarrhea develop hemolytic uremic syndrome (STEC HUS). Hemolytic uremic syndrome (HUS) is a disorder comprising of thrombocytopenia, microangiopathic hemolytic anemia, and acute kidney injury. The kidney is the most commonly affected organ and approximately half of the affected patients require dialysis. Other organ systems can also be affected including the central nervous system and the gastrointestinal, cardiac, and musculoskeletal systems. Neurological complicat...
Source: Pediatric Nephrology - October 29, 2019 Category: Urology & Nephrology Source Type: research

Two Liters a Day Keep the Doctor Away? Considerations on the Pathophysiology of Suboptimal Fluid Intake in the Common Population
Suboptimal fluid intake may require enhanced release of antidiuretic hormone (ADH) or vasopressin for the maintenance of adequate hydration. Enhanced copeptin levels (reflecting enhanced vasopressin levels) in 25% of the common population are associated with enhanced risk of metabolic syndrome with abdominal obesity, type 2 diabetes, hypertension, coronary artery disease, heart failure, vascular dementia, cognitive impairment, microalbuminuria, chronic kidney disease, inflammatory bowel disease, cancer, and premature mortality. Vasopressin stimulates the release of glucocorticoids which in turn up-regulate the serum- and g...
Source: Kidney and Blood Pressure Research - August 8, 2017 Category: Urology & Nephrology Source Type: research

Path of translational discovery of urological complications of obesity and diabetes
Diabetes mellitus (DM) is a prevalent chronic disease. Type 1 DM (T1DM) is a metabolic disorder that is characterized by hyperglycemia in the context of absolute lack of insulin, whereas type 2 DM (T2DM) is due to insulin resistance-related relative insulin deficiency. In comparison with T1DM, T2DM is more complex. The natural history of T2DM in most patients typically involves a course of obesity to impaired glucose tolerance, to insulin resistance, to hyperinsulinemia, to hyperglycemia, and finally to insulin deficiency. Obesity is a risk factor of T2DM. Diabetes causes some serious microvascular and macrovascular compli...
Source: AJP: Renal Physiology - May 15, 2017 Category: Urology & Nephrology Authors: Daneshgari, F., Liu, G., Hanna-Mitchell, A. T. Tags: REVIEW Source Type: research

Smoking and prevalence of nocturia in Japanese patients with type 2 diabetes mellitus: a post ‐hoc analysis of The Dogo Study
CONCLUSIONSIn Japanese patients with type 2 diabetes mellitus, current smoking may be independently inversely associated with severe nocturia.
Source: Neurourology and Urodynamics - August 25, 2016 Category: Urology & Nephrology Authors: Shinya Furukawa, Takenori Sakai, Tetsuji Niiya, Hiroaki Miyaoka, Teruki Miyake, Shin Yamamoto, Sayaka Kanzaki, Koutatsu Maruyama, Keiko Tanaka, Teruhisa Ueda, Hidenori Senba, Masamoto Torisu, Hisaka Minami, Morikazu Onji, Takeshi Tanigawa, Bunzo Matsuura, Tags: Original Clinical Article Source Type: research

Microvascular complications and prevalence of urgency incontinence in Japanese patients with type 2 diabetes mellitus: The dogo study
ConclusionsIn Japanese patients with type 2 diabetes mellitus, only diabetic neuropathy was independently positively associated with urgency incontinence. Neurourol. Urodynam. © 2015 Wiley Periodicals, Inc.
Source: Neurourology and Urodynamics - September 9, 2015 Category: Urology & Nephrology Authors: Shinya Furukawa, Takenori Sakai, Tetsuji Niiya, Hiroaki Miyaoka, Teruki Miyake, Shin Yamamoto, Koutatsu Maruyama, Teruhisa Ueda, Hidenori Senba, Yasuhiko Todo, Masamoto Torisu, Hisaka Minami, Morikazu Onji, Takeshi Tanigawa, Bunzo Matsuura, Yoichi Hiasa, Tags: Original Clinical Article Source Type: research

Serum Bicarbonate and Kidney Disease Progression and Cardiovascular Outcome in Patients With Diabetic Nephropathy: A Post Hoc Analysis of the RENAAL (Reduction of End Points in Non–Insulin-Dependent Diabetes With the Angiotensin II Antagonist Losartan) Study and IDNT (Irbesartan Diabetic Nephropathy Trial)
Conclusions In this cohort of patients with type 2 diabetes with nephropathy, serum bicarbonate level associations with kidney disease end points were not retained after adjustment for estimated glomerular filtration rate, which is in contrast to results of earlier studies in nondiabetic populations.
Source: American Journal of Kidney Diseases - August 21, 2015 Category: Urology & Nephrology Source Type: research

Visit-to-Visit Variability in Blood Pressure and Kidney and Cardiovascular Outcomes in Patients With Type 2 Diabetes and Nephropathy: A Post Hoc Analysis From the RENAAL Study and the Irbesartan Diabetic Nephropathy Trial
Conclusions In diabetic individuals with nephropathy, systolic blood pressure visit-to-visit variability is associated independently with hard kidney disease outcomes.
Source: American Journal of Kidney Diseases - October 29, 2014 Category: Urology & Nephrology Source Type: research