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糖尿病肾病的发病机制、生物标志物及治疗方法:当前见解与未来展望

Mechanisms, Biomarkers, and Treatment Approaches for Diabetic Kidney Disease: Current Insights and Future Perspectives.

作者信息

Joumaa Jean Paule, Raffoul Angela, Sarkis Charbel, Chatrieh Elizabeth, Zaidan Sally, Attieh Philippe, Harb Frederic, Azar Sami, Ghadieh Hilda E

机构信息

Department of Biomedical Sciences, Faculty of Medicine and Medical Sciences, University of Balamand, Al-Koura, Tripoli P.O. Box 100, Lebanon.

出版信息

J Clin Med. 2025 Jan 23;14(3):727. doi: 10.3390/jcm14030727.


DOI:10.3390/jcm14030727
PMID:39941397
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11818458/
Abstract

Diabetic Kidney Disease (DKD) is the leading cause of end-stage renal disease (ESRD) worldwide. Among individuals with type 1 diabetes mellitus (T1DM), 30-40% are at risk of developing DKD. This review focuses on the mechanistic processes, available and emerging biomarkers for diagnosing, monitoring, and preventing DKD, as well as treatment options targeted at DKD patients. A literature search was conducted on PubMed and Scopus using specific keywords. Inclusion and exclusion criteria were applied to select the articles used for this review. The literature highlights various mechanisms involved in the progression of DKD to more severe stages. Additionally, several biomarkers have been identified, which aid in diagnosing and monitoring the disease. Furthermore, numerous treatment approaches are being explored to address the underlying causes of DKD. Advanced research is exploring new medications to aid in DKD remission; sodium-glucose cotransport (SGLT2) inhibitors and finerenone, in particular, are gaining attention for their novel renoprotective effects. DKD is a major complication of diabetes, marked by complex and multifactorial mechanisms. Thus, understanding these processes is essential for developing targeted therapies to potentially reverse DKD progression. Biomarkers show promise for early diagnosis and monitoring of disease progression, while current treatment strategies underscore the importance of a multifaceted approach.

摘要

糖尿病肾病(DKD)是全球终末期肾病(ESRD)的主要原因。在1型糖尿病(T1DM)患者中,30%-40%有患DKD的风险。本综述重点关注DKD的发病机制、用于诊断、监测和预防DKD的现有及新出现的生物标志物,以及针对DKD患者的治疗选择。使用特定关键词在PubMed和Scopus上进行了文献检索。应用纳入和排除标准来选择用于本综述的文章。文献强调了DKD进展到更严重阶段所涉及的各种机制。此外,已确定了几种生物标志物,有助于诊断和监测该疾病。此外,正在探索多种治疗方法来解决DKD的根本原因。前沿研究正在探索有助于DKD缓解的新药物;尤其是钠-葡萄糖协同转运蛋白2(SGLT2)抑制剂和非奈利酮,因其新的肾脏保护作用而受到关注。DKD是糖尿病的一种主要并发症,其特点是机制复杂且具有多因素性。因此,了解这些过程对于开发可能逆转DKD进展的靶向治疗至关重要。生物标志物有望用于疾病进展的早期诊断和监测,而目前的治疗策略强调了多方面方法的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b21/11818458/426d46cff751/jcm-14-00727-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b21/11818458/1d76cb22eb8c/jcm-14-00727-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b21/11818458/426d46cff751/jcm-14-00727-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b21/11818458/1d76cb22eb8c/jcm-14-00727-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b21/11818458/426d46cff751/jcm-14-00727-g002.jpg

相似文献

[1]
Mechanisms, Biomarkers, and Treatment Approaches for Diabetic Kidney Disease: Current Insights and Future Perspectives.

J Clin Med. 2025-1-23

[2]
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Curr Med Chem. 2019

[3]
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Int Urol Nephrol. 2023-4

[4]
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Diabetes Metab J. 2021-1

[5]
Effects of metabolic memory on inflammation and fibrosis associated with diabetic kidney disease: an epigenetic perspective.

Clin Epigenetics. 2021-4-21

[6]
Renal Protection of Mineralocorticoid Receptor Antagonist, Finerenone, in Diabetic Kidney Disease.

Endocrinol Metab (Seoul). 2023-2

[7]
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Adv Ther. 2022-8

[8]
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Int J Mol Sci. 2022-11-9

[9]
Effects of canagliflozin versus finerenone on cardiorenal outcomes: exploratory post hoc analyses from FIDELIO-DKD compared to reported CREDENCE results.

Nephrol Dial Transplant. 2022-6-23

[10]
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引用本文的文献

[1]
Triglyceride glucose-body mass index is associated with diabetic kidney disease in type 2 diabetes mellitus patients without non-alcoholic fatty liver disease.

Front Nutr. 2025-7-16

[2]
Asprosin Levels in Adults with Type 2 Diabetes Mellitus and Diabetic Kidney Disease: A Systematic Review and Meta-Analysis.

Diabetes Metab Syndr Obes. 2025-7-23

[3]
Immune biomarkers as early indicators of renal damage in type 1 diabetic children: A step toward translational medicine.

World J Diabetes. 2025-6-15

[4]
Editorial: Cell cross-talk in diabetic kidney diseases, volume III.

Front Med (Lausanne). 2025-5-30

[5]
Tracing the molecular landscape of diabetic nephropathy: Insights from machine learning and experiment verification.

J Diabetes Investig. 2025-8

[6]
New Markers for the Assessment of Microvascular Complications in Patients with Metabolic Syndrome.

Metabolites. 2025-3-10

本文引用的文献

[1]
Inhibition of SGLT2 protects podocytes in diabetic kidney disease by rebalancing mitochondria-associated endoplasmic reticulum membranes.

Cell Commun Signal. 2024-11-7

[2]
The potential role of finerenone in patients with type 1 diabetes and chronic kidney disease.

Diabetes Obes Metab. 2024-10

[3]
Lipid metabolism disorder in diabetic kidney disease.

Front Endocrinol (Lausanne). 2024

[4]
The role of long non-coding RNAs in the development of diabetic kidney disease and the involved clinical application.

Diabetes Metab Res Rev. 2024-5

[5]
Recent Advances in the Management of Diabetic Kidney Disease: Slowing Progression.

Int J Mol Sci. 2024-3-7

[6]
Deciphering the role of MicroRNAs in diabetic nephropathy: Regulatory mechanisms and molecular insights.

Pathol Res Pract. 2024-4

[7]
The therapeutic effect of mesenchymal stem cells in diabetic kidney disease.

J Mol Med (Berl). 2024-4

[8]
Crosstalk among podocytes, glomerular endothelial cells and mesangial cells in diabetic kidney disease: an updated review.

Cell Commun Signal. 2024-2-19

[9]
'Oxidative stress'-A new target in the management of diabetes mellitus.

J Family Med Prim Care. 2023-11

[10]
Pathomechanisms of Diabetic Kidney Disease.

J Clin Med. 2023-11-27

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