Resistance to insulin and kidney disease in the cardiorenal metabolic syndrome; role for angiotensin II
► Insulin resistance without diabetes may be a feature of early stage kidney disease in the cardiorenal metabolic syndrome. ► Early proteinuria/microalbuminuria may predict presence and progression of kidney disease. ► Proteinuria in insulin resistant subjects may have glomerular/tubulointerstitial...
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| Published in | Molecular and cellular endocrinology Vol. 378; no. 1-2; pp. 53 - 58 |
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| Main Authors | , |
| Format | Journal Article |
| Language | English |
| Published |
Ireland
Elsevier Ireland Ltd
25.09.2013
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0303-7207 1872-8057 1872-8057 |
| DOI | 10.1016/j.mce.2013.02.005 |
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| Abstract | ► Insulin resistance without diabetes may be a feature of early stage kidney disease in the cardiorenal metabolic syndrome. ► Early proteinuria/microalbuminuria may predict presence and progression of kidney disease. ► Proteinuria in insulin resistant subjects may have glomerular/tubulointerstitial origins. ► Insulin may play an important role in salt homeostasis. ► Inappropriate RAAS activation is central to insulin resistance and kidney dysfunction.
The presence of insulin resistance is increasingly recognized as an important contributor to early stage kidney disease independent of the contribution of diabetes. Important in this relationship is the strong correlation between hyperinsulinemia and low levels of albuminuria (e.g. microalbuminuria). Recent work highlight mechanisms for glomerular/tubulointerstitial injury with excess insulin and emerging evidence identifies a unique role for insulin metabolic signaling and altered handling of salt reabsorption at the level of the proximal tubule. Evidence is also emerging for the role of insulin signaling in the glomerulus both epithelial and endothelial. Central to the mechanism of injury is inappropriate activation of the RAAS. |
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| AbstractList | The presence of insulin resistance is increasingly recognized as an important contributor to early stage kidney disease independent of the contribution of diabetes. Important in this relationship is the strong correlation between hyperinsulinemia and low levels of albuminuria (e.g. microalbuminuria). Recent work highlight mechanisms for glomerular/tubulointerstitial injury with excess insulin and emerging evidence identifies a unique role for insulin metabolic signaling and altered handling of salt reabsorption at the level of the proximal tubule. Evidence is also emerging for the role of insulin signaling in the glomerulus both epithelial and endothelial. Central to the mechanism of injury is inappropriate activation of the RAAS. ► Insulin resistance without diabetes may be a feature of early stage kidney disease in the cardiorenal metabolic syndrome. ► Early proteinuria/microalbuminuria may predict presence and progression of kidney disease. ► Proteinuria in insulin resistant subjects may have glomerular/tubulointerstitial origins. ► Insulin may play an important role in salt homeostasis. ► Inappropriate RAAS activation is central to insulin resistance and kidney dysfunction. The presence of insulin resistance is increasingly recognized as an important contributor to early stage kidney disease independent of the contribution of diabetes. Important in this relationship is the strong correlation between hyperinsulinemia and low levels of albuminuria (e.g. microalbuminuria). Recent work highlight mechanisms for glomerular/tubulointerstitial injury with excess insulin and emerging evidence identifies a unique role for insulin metabolic signaling and altered handling of salt reabsorption at the level of the proximal tubule. Evidence is also emerging for the role of insulin signaling in the glomerulus both epithelial and endothelial. Central to the mechanism of injury is inappropriate activation of the RAAS. The presence of insulin resistance is increasingly recognized as an important contributor to early stage kidney disease independent of the contribution of diabetes. Important in this relationship is the strong correlation between hyperinsulinemia and low levels of albuminuria (e.g. microalbuminuria). Recent work highlight mechanisms for glomerular/tubulointerstitial injury with excess insulin and emerging evidence identifies a unique role for insulin metabolic signaling and altered handling of salt reabsorption at the level of the proximal tubule. Evidence is also emerging for the role of insulin signaling in the glomerulus both epithelial and endothelial. Central to the mechanism of injury is inappropriate activation of the RAAS.The presence of insulin resistance is increasingly recognized as an important contributor to early stage kidney disease independent of the contribution of diabetes. Important in this relationship is the strong correlation between hyperinsulinemia and low levels of albuminuria (e.g. microalbuminuria). Recent work highlight mechanisms for glomerular/tubulointerstitial injury with excess insulin and emerging evidence identifies a unique role for insulin metabolic signaling and altered handling of salt reabsorption at the level of the proximal tubule. Evidence is also emerging for the role of insulin signaling in the glomerulus both epithelial and endothelial. Central to the mechanism of injury is inappropriate activation of the RAAS. |
| Author | Nistala, Ravi Whaley-Connell, Adam |
| AuthorAffiliation | 3 Harry S Truman VA Medical Center 1 University of Missouri School of Medicine, Diabetes and Cardiovascular Center, Departments of Internal Medicine, Divisions of Nephrology and Hypertension and 2 Dialysis Clinics, Inc, and the |
| AuthorAffiliation_xml | – name: 3 Harry S Truman VA Medical Center – name: 1 University of Missouri School of Medicine, Diabetes and Cardiovascular Center, Departments of Internal Medicine, Divisions of Nephrology and Hypertension and – name: 2 Dialysis Clinics, Inc, and the |
| Author_xml | – sequence: 1 givenname: Ravi surname: Nistala fullname: Nistala, Ravi email: nistalar@health.missouri.edu organization: University of Missouri School of Medicine, Diabetes and Cardiovascular Center, Departments of Internal Medicine, Divisions of Nephrology and Hypertension, United States – sequence: 2 givenname: Adam surname: Whaley-Connell fullname: Whaley-Connell, Adam organization: University of Missouri School of Medicine, Diabetes and Cardiovascular Center, Departments of Internal Medicine, Divisions of Nephrology and Hypertension, United States |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/23416840$$D View this record in MEDLINE/PubMed |
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| Keywords | Glomerulus Obesity Hyperinsulinemia Insulin resistance Chronic kidney disease Cardiorenal metabolic syndrome |
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| Snippet | ► Insulin resistance without diabetes may be a feature of early stage kidney disease in the cardiorenal metabolic syndrome. ► Early... The presence of insulin resistance is increasingly recognized as an important contributor to early stage kidney disease independent of the contribution of... |
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| SubjectTerms | Activation albuminuria Albuminuria - metabolism Albuminuria - pathology Angiotensin II - metabolism Animals Cardio-Renal Syndrome - metabolism Cardio-Renal Syndrome - pathology Cardiorenal metabolic syndrome Chronic kidney disease Correlation diabetes Glomerulus Humans Hyperinsulinemia Injuries Insulin Insulin Resistance Kidney diseases Kidney Glomerulus - metabolism Kidney Glomerulus - pathology Low level metabolic syndrome Metabolic Syndrome - metabolism Metabolic Syndrome - pathology Obesity Recognition Signal Transduction |
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| Title | Resistance to insulin and kidney disease in the cardiorenal metabolic syndrome; role for angiotensin II |
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