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Metabolic Changes and Oxidative Stress in Diabetic Kidney Disease

Diabetic kidney disease (DKD) is a major cause of end-stage kidney disease, and it is crucial to understand the pathophysiology of DKD. The control of blood glucose levels by various glucose-lowering drugs, the common use of inhibitors of the renin–angiotensin system, and the aging of patients with...

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Autores principales: Sakashita, Midori, Tanaka, Tetsuhiro, Inagi, Reiko
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8301131/
https://www.ncbi.nlm.nih.gov/pubmed/34356375
http://dx.doi.org/10.3390/antiox10071143
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author Sakashita, Midori
Tanaka, Tetsuhiro
Inagi, Reiko
author_facet Sakashita, Midori
Tanaka, Tetsuhiro
Inagi, Reiko
author_sort Sakashita, Midori
collection PubMed
description Diabetic kidney disease (DKD) is a major cause of end-stage kidney disease, and it is crucial to understand the pathophysiology of DKD. The control of blood glucose levels by various glucose-lowering drugs, the common use of inhibitors of the renin–angiotensin system, and the aging of patients with diabetes can alter the disease course of DKD. Moreover, metabolic changes and associated atherosclerosis play a major role in the etiology of DKD. The pathophysiology of DKD is largely attributed to the disruption of various cellular stress responses due to metabolic changes, especially an increase in oxidative stress. Therefore, many antioxidants have been studied as therapeutic agents. Recently, it has been found that NRF2, a master regulator of oxidative stress, plays a major role in the pathogenesis of DKD and bardoxolone methyl, an activator of NRF2, has attracted attention as a drug that increases the estimated glomerular filtration rate in patients with DKD. This review outlines the altered stress responses of cellular organelles in DKD, their involvement in the pathogenesis of DKD, and discusses strategies for developing therapeutic agents, especially bardoxolone methyl.
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spelling pubmed-83011312021-07-24 Metabolic Changes and Oxidative Stress in Diabetic Kidney Disease Sakashita, Midori Tanaka, Tetsuhiro Inagi, Reiko Antioxidants (Basel) Review Diabetic kidney disease (DKD) is a major cause of end-stage kidney disease, and it is crucial to understand the pathophysiology of DKD. The control of blood glucose levels by various glucose-lowering drugs, the common use of inhibitors of the renin–angiotensin system, and the aging of patients with diabetes can alter the disease course of DKD. Moreover, metabolic changes and associated atherosclerosis play a major role in the etiology of DKD. The pathophysiology of DKD is largely attributed to the disruption of various cellular stress responses due to metabolic changes, especially an increase in oxidative stress. Therefore, many antioxidants have been studied as therapeutic agents. Recently, it has been found that NRF2, a master regulator of oxidative stress, plays a major role in the pathogenesis of DKD and bardoxolone methyl, an activator of NRF2, has attracted attention as a drug that increases the estimated glomerular filtration rate in patients with DKD. This review outlines the altered stress responses of cellular organelles in DKD, their involvement in the pathogenesis of DKD, and discusses strategies for developing therapeutic agents, especially bardoxolone methyl. MDPI 2021-07-19 /pmc/articles/PMC8301131/ /pubmed/34356375 http://dx.doi.org/10.3390/antiox10071143 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Sakashita, Midori
Tanaka, Tetsuhiro
Inagi, Reiko
Metabolic Changes and Oxidative Stress in Diabetic Kidney Disease
title Metabolic Changes and Oxidative Stress in Diabetic Kidney Disease
title_full Metabolic Changes and Oxidative Stress in Diabetic Kidney Disease
title_fullStr Metabolic Changes and Oxidative Stress in Diabetic Kidney Disease
title_full_unstemmed Metabolic Changes and Oxidative Stress in Diabetic Kidney Disease
title_short Metabolic Changes and Oxidative Stress in Diabetic Kidney Disease
title_sort metabolic changes and oxidative stress in diabetic kidney disease
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8301131/
https://www.ncbi.nlm.nih.gov/pubmed/34356375
http://dx.doi.org/10.3390/antiox10071143
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