Afectación renal en la diabetes mellitus

  1. Barrio, F. Moreno
  2. Torres, C. Castillo
  3. Esparragoza, J.K. Peña
Revista:
Medicine: Programa de Formación Médica Continuada Acreditado

ISSN: 0304-5412

Año de publicación: 2019

Serie: 12

Número: 80

Páginas: 4735-4744

Tipo: Artículo

DOI: HTTPS://DOI.ORG/10.1016/J.MED.2019.05.031 DIALNET GOOGLE SCHOLAR

Otras publicaciones en: Medicine: Programa de Formación Médica Continuada Acreditado

Resumen

Resumen La diabetes mellitus se ha convertido en un importante problema de salud pública con más de 140 millones de personas afectas en la actualidad. Esta cifra puede llegar al 4% de la población mundial en 2030. La nefropatía diabética (ND) es la primera causa de enfermedad renal crónica terminal y de inicio de terapia sustitutiva renal. La ND puede aparecer tanto en la DM tipo 1 como en la DM tipo 2. El seguimiento precoz de los pacientes, a través de la determinación periódica de microalbuminuria y estimación del filtrado glomerular, ayudará a la detección precoz de la ND en la fase clínica inicial en la que aún es potencialmente reversible la proteinuria, impidiendo la progresión a la insuficiencia renal. En este sentido, es muy importante llevar a cabo un enfoque terapéutico multifactorial en el paciente diabético, con un control estricto de la glucemia, de las cifras de presión arterial y de los factores de riesgo vascular. Los fármacos bloqueantes del eje renina-angiotensina-aldosterona siguen teniendo un papel fundamental en el tratamiento de la diabetes, siendo los antihipertensivos de primera elección en estos pacientes.

Referencias bibliográficas

  • Adler AI, Stevens RJ, Manley SE, Bilous RW, Cull CA, Holman RR. Development and progression of nephropathy in type 2 diabetes: the United Kingdom Prospective Study (UKPDS 64). Kidney Int. 2003;63(1):225-32.
  • Adler S. Diabetic nephropathy: Linking histology, cell biology, and genetics. Kidney Int. 2004;66(5):2095-106.
  • Bailey RA, Wang Y, Zhu V, Rupnow MF. Chronic kidney disease in US adults with type 2 diabetes: an updated national estimate of prevalence based on Kidney Disease: Improving Global Outcomes (KDIGO) staging. BMC Res Notes. 2014;7(1):415.
  • Benigni A, Gagliardini E, Tomasoni S, Abbate M, Ruggenenti P, Kalluri R,. Selective impairment of gene expression and assembly of nephrin in human diabetic nephropathy. Kidney Int. 2004;65(6):2193-200.
  • Benigni A, Zoja C, Corna D, Zatelli C, Conti S, Campana M,. Add on anti-TGF-beta antibody to ACE inhibitor arrests progressive diabetic nephropathy in the rat. J Am Soc Nephrol. 2003;14(7):1816-24.
  • Bojestig M, Arnqvist HJ, Hermansson G, Karlberg BE, Ludvigsson J. Declining incidence of nephropathy in insulin dependent diabetes mellitus. N Engl J Med.1994;330(1):15-8
  • Breyer JA. Diabetic nephropathy in insulin dependent patients. Am J Kidney Dis. 1992;20(6):533-47.
  • Carter JS, Pugh JA, Monterrosa A. Noninsulin dependent diabetes mellitus in minorities in the United States. Ann Intern Med [Internet]. 1996;125(3):221-32.
  • Chang AS, Hathaway CK, Smithies O, Kakoki M. Transforming growth factor-β1 and diabetic nephropathy. Am J Physiol Physiol. 2016;310(8):F689-96.
  • Collins AJ, Foley RN, Gilbertson DT, Chen S-C. United States Renal Data System public health surveillance of chronic kidney disease and end stage renal disease. Kidney Int Suppl. 2015;5(1):2-7.
  • Cooper ME. Pathogenesis, prevention, and treatment of diabetic nephropathy. Lancet. 1998;352(9123):213-9.
  • De Boer IH, Bangalore S, Benetos A, Davis AM, Michos ED, Muntner P. Diabetes and hypertension: a position statement by the American Diabetes Association. Diabetes Care. 2017;40(9):1273-84.
  • De Zeeuw D, Remuzzi G, Parving H-H, Keane WF, Zhang Z, Sh-ahinfar S. Proteinuria, a target for renoprotection in patients with type 2 diabetic nephropathy: lessons from RENAAL. Kidney Int. 2004;65(6):2309-20.
  • Finne P, Reunanen A, Stenman S, Groop P-H, Grönhagen-Riska C. Incidence of end stage renal disease in patients with type 1 diabetes. JAMA. 2005;294(14):1782-7.
  • Gaede P, Vedel P, Larsen N, Jensen GVH, Parving H-H, Pedersen O. Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes. N Engl J Med. 2003;348(5):383-93.
  • Gurley SB, Coffman TM. An IRKO in the Podo: impaired insulin signaling in podocytes and the pathogenesis of diabetic nephropathy. Cell Metab. 2010;12(4):311-2.
  • Heilig CW, Concepcion LA, Riser BL, Freytag SO, Zhu M, Cortes P. Overexpression of glucose transporters in rat mesangial cells cultured in a normal glucose milieu mimics the diabetic phenotype. J Clin Invest. 1995;96(4):1802-14.
  • Hostetter TH. Prevention of end-stage renal disease due to type 2 diabetes. N Engl J Med. 2001;345(12):910-2.
  • Lindblom R, Higgins G, Coughlan M, de Haan JB. Targeting mitochondria and reactive oxygen species driven pathogenesis in diabetic nephropathy. Rev Diabet Stud. 2015;12(1-2):134-56.
  • Mann JFE, Ørsted DD, Brown-Frandsen K, Marso SP, Poulter NR, Rasmussen S. Liraglutide and renal outcomes in type 2 diabetes. N Engl J Med. 2017;377(9):839-48.
  • Mogensen CE. The kidney in diabetes: how to control renal and related cardiovascular complications. Am J Kidney Dis. 2001;37(1)Suppl 2:S2-6.
  • Murphy SW, Foley RN, Barrett BJ, Kent GM, Morgan J, Barré P. Comparative mortality of hemodialysis and peritoneal dialysis in Canada. Kidney Int. 2000;57(4):1720-6.
  • Nathan DM, Zinman B, Cleary PA, Backlund J-YC, Genuth S, Miler R. Modern day clinical course of type 1 diabetes mellitus after 30 years’ duration. Arch Intern Med. 2009;169(14):1307.
  • Parving H-H, Brenner BM, McMurray JJV, de Zeeuw D, Haffner SM, Solomon SD. Cardiorenal end points in a trial of aliskiren for type 2 diabetes. N Engl J Med. 2012;367(23):2204-13.
  • Parving HH, Hommel E, Jensen BR, Hansen HP. Long term beneficial effect of ACE inhibition on diabetic nephropathy in normotensive type 1 diabetic patients. Kidney Int. 2001;60(1):228-34.
  • Rachmani R, Slavachevsky I, Amit M, Levi Z, Kedar Y, Berla M. The effect of spironolactone, cilazapril and their combination on albuminuria in patients with hypertension and diabetic nephropathy is independent of blood pressure reduction: a randomized controlled study. Diabet Med. 2004;21(5): 471-5.
  • Sanajou D, Ghorbani Haghjo A, Argani H, Aslani S. AGE-RAGE axis blockade in diabetic nephropathy: Current status and future directions. Eur J Pharmacol. 2018;833:158-64.
  • Sandholm N, Van Zuydam N, Ahlqvist E, Juliusdottir T, Desh-mukh HA, Rayner NW. The genetic landscape of renal complications in type 1 diabetes. J Am Soc Nephrol. 2017;28(2):557-74.
  • Skupien J, Smiles AM, Valo E, Ahluwalia TS, Gyorgy B, Sandholm N. Variations in risk of end stage renal disease and risk of mortality in an international study of patients with type 1 diabetes and advanced nephropathy. Diabetes Care. 2019;42(1):93-101.
  • Tervaert TWC, Mooyaart AL, Amann K, Cohen AH, Cook HT, Drachenberg CB. Pathologic classification of diabetic nephropathy. J Am Soc Nephrol. 2010;21(4):556-63.
  • Tonneijck L, Muskiet MHA, Smits MM, van Bommel EJ, Heerspink HJL, van Raalte DH. Glomerular hyperfiltration in diabetes: mechanisms, clinical significance, and treatment. J Am Soc Nephrol. 2017;28(4):1023-39.
  • Trevisan R, Viberti G. Genetic factors in the development of diabetic nephropathy. J Lab Clin Med. 1995;126(4):342-9.
  • Van den Hoven MJ, Rops AL, Bakker MA, Aten J, Rutjes N, Roestenberg P. Increased expression of heparanase in overt diabetic nephropathy. Kidney Int. 2006;70(12):2100-8.
  • Vonesh EF, Snyder JJ, Foley RN, Collins AJ. The differential impact of risk factors on mortality in hemodialysis and peritoneal dialysis. Kidney Int. 2004;66(6):2389-401.
  • Whelton PK, Carey RM, Aronow WS, Casey DE, Collins KJ, Den-nison Himmelfarb C. 2017 Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension. 2018;71(6):e13-e115.
  • Zelniker TA, Wiviott SD, Raz I, Im K, Goodrich EL, Bonaca MP. SGLT2 inhibitors for primary and secondary prevention of cardiovascular and renal outcomes in type 2 diabetes: a systematic review and meta-analysis of cardiovascular outcome trials. Lancet. 2019;393(10166): 31-9.