Diabetic Kidney Disease

189 Pages·2021·4.879 MB·English

by  Takashi Wada, Kengo Furuichi, Naoki Kashihara (ed.)

Diabetic
Kidney Disease
Takashi Wada
Kengo Furuichi
Naoki Kashihara
Editors
123
Diabetic Kidney Disease
Takashi Wada • Kengo Furuichi
Naoki Kashihara
Editors
Diabetic Kidney Disease
Editors
Takashi Wada Kengo Furuichi
Department of Nephrology and Laboratory Department of Nephrology
Kanazawa University Kanazawa Medical University
Kanazawa, Ishikawa Kanazawa, Ishikawa
Japan Japan
Naoki Kashihara
Department of Nephrology and
Hypertension
Kawasaki Medical School
Kurashiki, Okayama
Japan
ISBN 978-981-15-9300-0 ISBN 978-981-15-9301-7 (eBook)
https://doi.org/10.1007/978-981-15-9301-7
© Springer Nature Singapore Pte Ltd. 2021
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Preface
Diabetic kidney disease is the leading cause of end-stage kidney disease requiring
renal replacement therapy. Nowadays, the circumstances in aging society affect and
alter the clinico-pathological phenotypes and kidney prognosis in diabetic patients.
With these trends, the terms of diabetic kidney disease may be used for clinical
approach for diabetes-related kidney disease, in which further discussion would be
required for pathophysiology, therapy, and prognosis.
The purpose of this book is to provide the latest information on clinico-
pathological features of diabetic kidney disease, especially based on results from a
cohort of biopsy-proven diabetic nephropathy patients with long-term medical
observation and long-term registry for diabetic kidney disease and recent progress
in pathophysiology. Biopsy-proven diabetic nephropathy cohort increases the value
of clinical and experimental settings. Therefore, these will clearly provide the
readers with clinico-pathological axis in clinical and experimental settings,
including differential pathological/clinical diagnoses of chronic kidney disease in
diabetic patients (e.g., the presence of “classical” diabetic nephropathy and/or
nephrosclerosis and/or other primary kidney diseases). Therefore, the description of
this book is very informative for all physicians and researchers all over the world in
this field.
We gratefully thank all contributors for preparing their manuscripts and chapters
for a better understanding of the current status of diabetic kidney disease. We are
further thankful to Springer Nature, especially Vignesh Iyyadurai Suresh and
Sachiko Hayakawa for their patience and invaluable advice.
Kanazawa, Japan Takashi Wada
Kanazawa, Japan Kengo Furuichi
Kurashiki, Japan Naoki Kashihara
v
Contents
Part I Clinical Aspects
1 Clinical Epidemiology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Tadashi Toyama
2 The Japanese Registries of Diabetic Nephropathy/Diabetic
Kidney Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Miho Shimizu and Takashi Wada
3 Diabetic Kidney Disease and Cardiovascular Disease . . . . . . . . . . . . . 31
Kumiko Muta, Yoko Obata, and Tomoya Nishino
4 Possible Biomarkers for Diabetic Kidney Disease . . . . . . . . . . . . . . . . 47
Yukio Yuzawa and Daijo Inaguma
5 Blood Pressure Management in Diabetic Kidney Disease . . . . . . . . . . 61
Naoki Kashihara
6 Glycemic Control and Future Perspectives for Treatment . . . . . . . . . 73
Satoshi Miyamoto and Kenichi Shikata
7 Nutrition and Diet Therapy for DKD . . . . . . . . . . . . . . . . . . . . . . . . . . 87
Shinji Kume
8 Renal Structural-Functional Relationships at the Early Stage
of Diabetic Nephropathy Among Types 1 and 2 Diabetes:
Similarity and Difference . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
Tatsumi Moriya
9 Study at AMED Collecting 600 Biopsy-P roven Diabetic
Nephropathies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119
Kengo Furuichi
vii
viii Contents
Part II Pathological Aspects
10 Evaluation of Diabetic Kidney Lesions . . . . . . . . . . . . . . . . . . . . . . . . . 135
Junichi Hoshino
11 Nephrosclerosis and Diabetic Kidney Disease . . . . . . . . . . . . . . . . . . . 149
Masayuki Yamanouchi, Kengo Furuichi, and Takashi Wada
12 Nondiabetic Renal Disease (NDRD) and Diabetic Kidney Disease
(DKD) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159
Koki Mise
13 Experimental Animal Models of Diabetic Kidney Disease . . . . . . . . . 173
Shinya Nagasaka and Akira Shimizu
Part I
Clinical Aspects
Chapter 1
Clinical Epidemiology
Tadashi Toyama
DKD is a disease concept that has received much attention in recent years. The defi-
nition of DKD is not yet well established and may vary from studies. On the other
hand, the importance of DKD as a risk factor, its high incidence, or a specific condi-
tion such as normoalbuminuric DKD is getting a lot of attention. This chapter out-
lines the definition of DKD, its role as a risk factor, the international incidence of
the disease, and characteristics of normoalbuminuric DKD.
1.1 Definition of DKD
Diabetic nephropathy is clinically diagnosed when the major features of diabetic
nephropathy, albuminuria (>300 mg/24 h or 200 μg/min), and diabetic retinopathy
are found and other kidney diseases are excluded [1]. Studies have revealed that not
only albuminuria but also reduced GFR is a risk factor for ESKD and cardiovascular
diseases (CVD) [2, 3]. Furthermore, in recent years, diabetic patients with reduced
GFR and normoalbuminuria have been increasing [4]. Due to such clinical evidence
and changes in disease structure, the concept of disease called DKD, which is a
CKD with diabetes, has become widespread. There is no widely accepted definition
of DKD, but American Diabetes Association (ADA) said “DKD is usually a clinical
diagnosis made based on the presence of albuminuria and/or reduced eGFR in the
absence of sign or symptoms of other primary causes of kidney damage” [5].
DKD is a major microvascular complication of diabetes. Increasing number of
ESKD requiring dialysis or kidney transplantation is a worldwide burden, and DKD
is a major cause of ESKD in many high-income or upper-middle-income countries.
T. Toyama (*)
Division of Nephrology, Kanazawa University Hospital, Kanazawa, Japan
e-mail: [email protected]
© Springer Nature Singapore Pte Ltd. 2021 3
T. Wada et al. (eds.), Diabetic Kidney Disease,
https://doi.org/10.1007/978-981-15-9301-7_1
4 T. Toyama
1.2 Prevalence of Diabetes
The International Diabetes Federation reported that the prevalence of diabetes in
global estimates was 9.3% (Fig. 1.1), and 463.0 million adults aged 20–79 years are
suffering from diabetes [6]. The total number of diabetes has been increasing
worldwide [7]. Considering the global situation of diabetes, concern about the
future burden of DKD is increasing.
1.3 Incidence of DKD
The United Kingdom Prospective Diabetes Study (UKPDS 64) followed 5097
patients with type 2 diabetes and revealed annual incidence of DKD by its stage [8]
(Fig.  1.2). The incidence rates of normoalbuminuria to microalbuminuria,
microalbuminuria to macroalbuminuria, and macroalbuminuria to ESKD were
2.0%, 2.8%, and 2.3%, respectively. It is noteworthy that the all-cause mortality rate
is equal to or greater than the progression rate of nephropathy. As reported in other
studies, the most common cause of death is cardiovascular disease (CVD), and
<4%
4−<5%
5−<7%
7−<9%
9−<12%
≥12%
No estimates made
Fig. 1.1 Estimated age-adjusted prevalence of diabetes in adults (20–79 years), 2019 [7]