Transforming growth factor β contributes to progressive diabetic nephropathy
Year: 2000
Type: article
Abstract: Renal failure is a common and serious complication of longstanding diabetes mellitus. Diabetes is now the most common cause of end-stage renal failure requiring dialysis in the United States, accounting for almost 40% of all new dialysis patients (1). Moreover, the incidence of renal failure caused by diabetes, particularly type II diabetes, is rising dramatically worldwide (2). Compounding the tragedy of the explosive growth in the incidence renal failure caused by diabetes is the grim reality that the survival of patients with renal failure caused by diabetes is much worse than that of patients with renal failure resulting from other causes. In Germany, for example, Koch et al. (3) reported a 5-year survival of only 5% among patients with type II diabetes undergoing dialysis. Fortunately, progress is being made in our understanding of the pathogenesis of diabetic renal disease and in our ability to delay, or even prevent, this devastating complication. Two studies appearing in this issue of PNAS (4, 5) are illustrative of this progress. Diabetic nephropathy refers to a characteristic set of structural and functional kidney abnormalities that occur in patients with diabetes. Although best described in patients with type I diabetes (6), similar findings are now known to occur in the more common type II diabetic patient (7). Structural abnormalities include hypertrophy of the kidney, an increase in the thickness of glomerular basement membranes, accumulation of extracellular matrix components in the glomerulus (nodular and diffuse glomerulosclerosis), tubular atrophy, and interstitial fibrosis (6, 7). Functional alterations include an early increase in the glomerular filtration rate with intraglomerular hypertension, subsequent proteinuria, systemic hypertension, and eventual loss of renal function (8).
Authors: W. Brian Reeves, Thomas E. Andreoli
Language: English
Subfield: Nephrology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2102115518