Uremic cardiomyopathy and insulin resistance: a critical role for akt?
Uremic cardiomyopathy is a classic complication of chronic renal failure whose cause is unclear and treatment remains disappointing. Insulin resistance is an independent predictor of cardiovascular mortality in chronic renal failure. Underlying insulin resistance are defects in insulin signaling through the protein kinase, Akt. Akt acts as a nodal point in the control of both the metabolic and pleiotropic effects of insulin. Imbalance among these effects leads to cardiac hypertrophy, fibrosis, and apoptosis; less angiogenesis; metabolic remodeling; and altered calcium cycling, all key features of uremic cardiomyopathy. Here we consider the role of Akt in the development of uremic cardiomyopathy, drawing parallels from models of hypertrophic cardiac disease.
Semple
David
D
Department of Biological Sciences, University of Hull, Kingston-upon-Hull, HU6 7RX, UK.
Smith
Katie
K
Bhandari
Sunil
S
Seymour
Anne-Marie L
AM
D017209:Apoptosis; D002118:Calcium / Q000378:metabolism; D006332:Cardiomegaly / Q000209:etiology; D009202:Cardiomyopathies / Q000209:etiology*; D005355:Fibrosis; D006801:Humans; D007333:Insulin Resistance; D009206:Myocardium / Q000378:metabolism / Q000473:pathology; D018919:Neovascularization, Physiologic; D051057:Proto-Oncogene Proteins c-akt / Q000502:physiology*; D053498:Sarcoplasmic Reticulum Calcium-Transporting ATPases / Q000502:physiology; D015398:Signal Transduction / Q000502:physiology; D014511:Uremia / Q000150:complications* / Q000378:metabolism
D051057:Proto-Oncogene Proteins c-akt; D053498:Sarcoplasmic Reticulum Calcium-Transporting ATPases; D002118:Calcium