title: Diabetic Nephropathy: Perspective on Novel Molecular Mechanisms.
abstract: Diabetes mellitus (DM) is the major cause of end-stage renal disease (ESRD) globally, and novel treatments are urgently needed. Current therapeutic approaches for diabetic nephropathy (DN) are focussing on blood pressure control with inhibitors of the renin-angiotensin-aldosterone system, on glycaemic and lipid control, and life-style changes. In this review, we highlight new molecular insights aiding our understanding of the initiation and progression of DN, including glomerular insulin resistance, dysregulation of cellular substrate utilisation, podocyte-endothelial communication, and inhibition of tubular sodium coupled glucose reabsorption. We believe that these mechanisms offer new therapeutic targets that can be exploited to develop important renoprotective treatments for DN over the next decade.
authors.affiliation: Cardiovascular Division, King's College London, London, SE1 9NH, UK. Electronic address: luigi.gnudi@kcl.ac.uk.
authors.forename: Luigi
authors.initials: L
authors.lastname: Gnudi
authors.affiliation: Academic Renal Unit, Dorothy Hodgkin Building, University of Bristol, Whitson Street, Bristol BS1 3NY, UK.
authors.forename: Richard J M
authors.initials: RJM
authors.lastname: Coward
authors.affiliation: Developmental Biology and Cancer Programme, Institute of Child Health, University College London, London, WC1N 1EH, UK. Electronic address: d.long@ucl.ac.uk.
authors.forename: David A
authors.initials: DA
authors.lastname: Long
mesh_terms: D001786:Blood Glucose / Q000378:metabolism; D003928:Diabetic Nephropathies / Q000235:genetics / Q000378:metabolism*; D006801:Humans; D007333:Insulin Resistance / Q000235:genetics / Q000502:physiology; D007678:Kidney Glomerulus / Q000378:metabolism; D018384:Oxidative Stress / Q000235:genetics / Q000502:physiology; D012084:Renin-Angiotensin System / Q000235:genetics / Q000502:physiology; D051297:Sodium-Glucose Transporter 2 / Q000235:genetics / Q000378:metabolism
chemical_list: D001786:Blood Glucose; D051297:Sodium-Glucose Transporter 2
keywords: SGLT2; diabetes; endothelium; glomerulus; oxidative stress; podocytes