title: Diabetic Kidney Disease in Adolescents With Type 2 Diabetes: New Insights and Potential Therapies.
abstract: Diabetic kidney disease (DKD) is the leading cause of end-stage renal disease (ESRD) and dialysis in the Western world. Early DKD, including microalbuminuria and renal hyperfiltration, is common in adolescents with type 2 diabetes (T2D). Furthermore, youth-onset T2D carries a higher risk of progressive DKD than adult-onset T2D of similar diabetes duration. DKD is characterized by a long clinically silent period without signs of disease. Therefore, a major challenge in preventing DKD is the difficulty in identifying high-risk T2D patients at an early stage. The Type 2 Diabetes in Adolescents and Youth (TODAY) study demonstrated a high initial prevalence that increased over time, irrespective of treatment arm. This key observation underscores the importance of discovering new therapeutic targets to supplement conventional management, in order to reduce DKD risk. In this review, we focus on early DKD in T2D and summarize potential novel biomarkers and therapeutic targets.
authors.affiliation: Department of Pediatric Endocrinology, University of Colorado School of Medicine, Aurora, CO, USA. petter.bjornstad@childrenscolorado.org.|Barbara Davis Center for Diabetes, University of Colorado School of Medicine, 13123 East 16th Ave, Box B265, Aurora, CO, 80045, USA. petter.bjornstad@childrenscolorado.org.
authors.forename: Petter
authors.initials: P
authors.lastname: Bjornstad
authors.affiliation: Department of Medicine, Division of Nephrology, Toronto General Hospital, University of Toronto, Toronto, ON, Canada.
authors.forename: David Z
authors.initials: DZ
authors.lastname: Cherney
authors.affiliation: Department of Pediatric Endocrinology, University of Colorado School of Medicine, Aurora, CO, USA.|Barbara Davis Center for Diabetes, University of Colorado School of Medicine, 13123 East 16th Ave, Box B265, Aurora, CO, 80045, USA.|Department of Medicine, Division of Nephrology, University of Colorado, Aurora, CO, USA.
authors.forename: David M
authors.initials: DM
authors.lastname: Maahs
authors.affiliation: Department of Pediatric Endocrinology, University of Colorado School of Medicine, Aurora, CO, USA.|Barbara Davis Center for Diabetes, University of Colorado School of Medicine, 13123 East 16th Ave, Box B265, Aurora, CO, 80045, USA.
authors.forename: Kristen J
authors.initials: KJ
authors.lastname: Nadeau
mesh_terms: D000293:Adolescent; D000419:Albuminuria; D000818:Animals; D015415:Biomarkers / Q000032:analysis; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000628:therapy*; D003928:Diabetic Nephropathies / Q000628:therapy*; D005919:Glomerular Filtration Rate; D006801:Humans; D012307:Risk Factors
chemical_list: D015415:Biomarkers
keywords: Albuminuria; Creatinine; Cystatin C; Diabetic kidney disease; Glomerular filtration rate (GFR); Impaired GFR; Iohexol; Rapid GFR decline; Renal hyperfiltration