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Diabetic Kidney Disease Takashi Wada Kengo Furuichi Naoki Kashihara Editors
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Diabetic Kidney Disease
Takashi Wada • Kengo Furuichi Naoki Kashihara Editors
Diabetic Kidney Disease
Editors Takashi Wada Department of Nephrology and Laboratory Kanazawa University Kanazawa, Ishikawa Japan
Kengo Furuichi Department of Nephrology Kanazawa Medical University Kanazawa, Ishikawa 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 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, expressed or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. This Springer imprint is published by the registered company Springer Nature Singapore Pte Ltd. The registered company address is: 152 Beach Road, #21-01/04 Gateway East, Singapore 189721, Singapore
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
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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-Proven Diabetic Nephropathies������������������������������������������������������������������������������������������ 119 Kengo Furuichi
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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 definition 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 condition such as normoalbuminuric DKD is getting a lot of attention. This chapter outlines 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 T. Wada et al. (eds.), Diabetic Kidney Disease, https://doi.org/10.1007/978-981-15-9301-7_1
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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