title: Resistance to insulin and kidney disease in the cardiorenal metabolic syndrome; role for angiotensin II.
abstract: The presence of insulin resistance is increasingly recognized as an important contributor to early stage kidney disease independent of the contribution of diabetes. Important in this relationship is the strong correlation between hyperinsulinemia and low levels of albuminuria (e.g. microalbuminuria). Recent work highlight mechanisms for glomerular/tubulointerstitial injury with excess insulin and emerging evidence identifies a unique role for insulin metabolic signaling and altered handling of salt reabsorption at the level of the proximal tubule. Evidence is also emerging for the role of insulin signaling in the glomerulus both epithelial and endothelial. Central to the mechanism of injury is inappropriate activation of the RAAS.
authors: University of Missouri School of Medicine, Diabetes and Cardiovascular Center, Departments of Internal Medicine, Divisions of Nephrology and Hypertension, United States; Dialysis Clinics Inc., Lemone Industrial Blvd., Columbia MO, United States. Electronic address: nistalar@health.missouri.edu.
authors: Ravi
authors: R
authors: Nistala
authors: Adam
authors: A
authors: Whaley-Connell
mesh_terms: D000419:Albuminuria / Q000378:metabolism / Q000473:pathology; D000804:Angiotensin II / Q000378:metabolism*; D000818:Animals; D059347:Cardio-Renal Syndrome / Q000378:metabolism* / Q000473:pathology; D006801:Humans; D007333:Insulin Resistance; D007678:Kidney Glomerulus / Q000378:metabolism / Q000473:pathology; D024821:Metabolic Syndrome / Q000378:metabolism* / Q000473:pathology; D015398:Signal Transduction
chemical_list: D000804:Angiotensin II
keywords: Cardiorenal metabolic syndrome; Chronic kidney disease; Glomerulus; Hyperinsulinemia; Insulin resistance; Obesity