Microvascular complications of diabetes mellitus: renal protection accompanies cardiovascular protection.
The microvascular complications of diabetes mellitus confer substantial morbidity and impair patient quality of life. Dyslipidemia and prolonged hyperglycemia promote an increase in oxidative stress, inflammation, and vascular damage, which together promote endothelial dysfunction and are associated with macrovascular and microvascular complications. Microalbuminuria is an early marker of diabetic nephropathy and an independent risk factor for cardiovascular disease. Diabetic nephropathy is the most common cause of end-stage renal disease in developed countries, and its prevalence is increasing. Preventing or limiting the progression of diabetic nephropathy, as demonstrated in the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) trial, may prevent or delay renal complications, as well as convey important cardioprotective benefits in patients with type 2 diabetes.
Brown
W Virgil
WV
Emory University School of Medicine, Atlanta, Georgia 30033, USA. w.virgil.brown@med.va.gov
D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003928:Diabetic Nephropathies / Q000209:etiology / Q000517:prevention & control*; D018450:Disease Progression; D050171:Dyslipidemias / Q000150:complications; D004730:Endothelium, Vascular / Q000473:pathology; D011345:Fenofibrate / Q000627:therapeutic use*; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D007249:Inflammation; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000517:prevention & control; D018384:Oxidative Stress; D012307:Risk Factors
D000960:Hypolipidemic Agents; D011345:Fenofibrate