Diabetic Nephropathy and its two phenotypes: the proteinuric and non-proteinuric
Autor(a) principal: | |
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Data de Publicação: | 2017 |
Outros Autores: | , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692017000200005 |
Resumo: | The typical progression of diabetic nephropathy is from the normoalbuminuric stage to microalbuminuria (urinary albumin creatinine rate, UACR, 30-300 mg/g) to end in overt proteinuria. A growing body of recent evidence has shown an accelerated decrease in glomerular filtration rate predominately seen in normoalbuminuric patients with type 2 diabetes. This discovery raises the the possibility of there being two independent diabetic nephropathy phenotypes. The aim of this review is to collect, summarize and compare the most relevant data referring to both the classical/proteinuric (UACR>300mg/g) and the non-classical/ non-proteinuric (UACR < 300 mg/g) phenotypes in type 2 diabetic patients. PubMed research into diabetic nephropathy and both proteinuric and non-proteinuric phenotypes was undertaken. A total of 67 articles were included. Several studies have shown that diabetic nephropathy may co-exist within a normal range of albumin excretion. This new emerging phenotype is nowadays extremely frequent in type 2 diabetic patients, and seems to be found more often in female sex, older adults, and patients with metabolic syndrome. Albumin does not seem to be the best marker for this phenotype. New possible markers for early stage renal disease were found. Treatment with Renin-Angiotensin-System inhibitors, according to evidence, might not be the most adequate therapy for non-proteinuric diabetic patients. Prognosis is still unclear. This new diabetic nephropathy phenotype exists and clinicians should be aware of it, to ensure these patients are not underdiagnosed. More research is needed to clarify this phenotypes epidemiology, pathogenesis, risk factors, diagnosis methods, new biomarkers, best treatment approach and its prognosis |
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Diabetic Nephropathy and its two phenotypes: the proteinuric and non-proteinuricAlbuminuriaDiabetes mellitustype 2Diabetic nephropathiesGlomerular Filtration RateRenal InsufficiencychronicThe typical progression of diabetic nephropathy is from the normoalbuminuric stage to microalbuminuria (urinary albumin creatinine rate, UACR, 30-300 mg/g) to end in overt proteinuria. A growing body of recent evidence has shown an accelerated decrease in glomerular filtration rate predominately seen in normoalbuminuric patients with type 2 diabetes. This discovery raises the the possibility of there being two independent diabetic nephropathy phenotypes. The aim of this review is to collect, summarize and compare the most relevant data referring to both the classical/proteinuric (UACR>300mg/g) and the non-classical/ non-proteinuric (UACR < 300 mg/g) phenotypes in type 2 diabetic patients. PubMed research into diabetic nephropathy and both proteinuric and non-proteinuric phenotypes was undertaken. A total of 67 articles were included. Several studies have shown that diabetic nephropathy may co-exist within a normal range of albumin excretion. This new emerging phenotype is nowadays extremely frequent in type 2 diabetic patients, and seems to be found more often in female sex, older adults, and patients with metabolic syndrome. Albumin does not seem to be the best marker for this phenotype. New possible markers for early stage renal disease were found. Treatment with Renin-Angiotensin-System inhibitors, according to evidence, might not be the most adequate therapy for non-proteinuric diabetic patients. Prognosis is still unclear. This new diabetic nephropathy phenotype exists and clinicians should be aware of it, to ensure these patients are not underdiagnosed. More research is needed to clarify this phenotypes epidemiology, pathogenesis, risk factors, diagnosis methods, new biomarkers, best treatment approach and its prognosisSociedade Portuguesa de Nefrologia2017-06-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articletext/htmlhttp://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692017000200005Portuguese Journal of Nephrology & Hypertension v.31 n.2 2017reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttp://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692017000200005Silva,ReginaMeng,CatarinaCoentrão,Luísinfo:eu-repo/semantics/openAccess2024-02-06T17:04:55Zoai:scielo:S0872-01692017000200005Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T02:18:58.406190Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Diabetic Nephropathy and its two phenotypes: the proteinuric and non-proteinuric |
title |
Diabetic Nephropathy and its two phenotypes: the proteinuric and non-proteinuric |
spellingShingle |
Diabetic Nephropathy and its two phenotypes: the proteinuric and non-proteinuric Silva,Regina Albuminuria Diabetes mellitus type 2 Diabetic nephropathies Glomerular Filtration Rate Renal Insufficiency chronic |
title_short |
Diabetic Nephropathy and its two phenotypes: the proteinuric and non-proteinuric |
title_full |
Diabetic Nephropathy and its two phenotypes: the proteinuric and non-proteinuric |
title_fullStr |
Diabetic Nephropathy and its two phenotypes: the proteinuric and non-proteinuric |
title_full_unstemmed |
Diabetic Nephropathy and its two phenotypes: the proteinuric and non-proteinuric |
title_sort |
Diabetic Nephropathy and its two phenotypes: the proteinuric and non-proteinuric |
author |
Silva,Regina |
author_facet |
Silva,Regina Meng,Catarina Coentrão,Luís |
author_role |
author |
author2 |
Meng,Catarina Coentrão,Luís |
author2_role |
author author |
dc.contributor.author.fl_str_mv |
Silva,Regina Meng,Catarina Coentrão,Luís |
dc.subject.por.fl_str_mv |
Albuminuria Diabetes mellitus type 2 Diabetic nephropathies Glomerular Filtration Rate Renal Insufficiency chronic |
topic |
Albuminuria Diabetes mellitus type 2 Diabetic nephropathies Glomerular Filtration Rate Renal Insufficiency chronic |
description |
The typical progression of diabetic nephropathy is from the normoalbuminuric stage to microalbuminuria (urinary albumin creatinine rate, UACR, 30-300 mg/g) to end in overt proteinuria. A growing body of recent evidence has shown an accelerated decrease in glomerular filtration rate predominately seen in normoalbuminuric patients with type 2 diabetes. This discovery raises the the possibility of there being two independent diabetic nephropathy phenotypes. The aim of this review is to collect, summarize and compare the most relevant data referring to both the classical/proteinuric (UACR>300mg/g) and the non-classical/ non-proteinuric (UACR < 300 mg/g) phenotypes in type 2 diabetic patients. PubMed research into diabetic nephropathy and both proteinuric and non-proteinuric phenotypes was undertaken. A total of 67 articles were included. Several studies have shown that diabetic nephropathy may co-exist within a normal range of albumin excretion. This new emerging phenotype is nowadays extremely frequent in type 2 diabetic patients, and seems to be found more often in female sex, older adults, and patients with metabolic syndrome. Albumin does not seem to be the best marker for this phenotype. New possible markers for early stage renal disease were found. Treatment with Renin-Angiotensin-System inhibitors, according to evidence, might not be the most adequate therapy for non-proteinuric diabetic patients. Prognosis is still unclear. This new diabetic nephropathy phenotype exists and clinicians should be aware of it, to ensure these patients are not underdiagnosed. More research is needed to clarify this phenotypes epidemiology, pathogenesis, risk factors, diagnosis methods, new biomarkers, best treatment approach and its prognosis |
publishDate |
2017 |
dc.date.none.fl_str_mv |
2017-06-01 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692017000200005 |
url |
http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692017000200005 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692017000200005 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Sociedade Portuguesa de Nefrologia |
publisher.none.fl_str_mv |
Sociedade Portuguesa de Nefrologia |
dc.source.none.fl_str_mv |
Portuguese Journal of Nephrology & Hypertension v.31 n.2 2017 reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
repository.mail.fl_str_mv |
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1799137279670747136 |