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      Update on the Mechanisms of Tubular Cell Injury in Diabetic Kidney Disease

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          Abstract

          Increasing evidence supports a role of proximal tubular (PT) injury in the progression of diabetic kidney disease (DKD), in patients with or without proteinuria. Research on the mechanisms of the PT injury in DKD could help us to identify potential new biomarkers and drug targets for DKD. A high glucose transport state and mismatched local hypoxia in the PT of diabetes patients may be the initiating factors causing PT injury. Other mechanism such as mitochondrial dysfunction, reactive oxygen species (ROS) overproduction, ER stress, and deficiency of autophagy interact with each other leading to more PT injury by forming a vicious circle. PT injury eventually leads to the development of tubulointerstitial inflammation and fibrosis in DKD. Many downstream signaling pathways have been demonstrated to mediate these diseased processes. This review focuses mostly on the novel mechanisms of proximal renal tubular injury in DKD and we believe such review could help us to better understand the pathogenesis of DKD and identify potential new therapies for this disease.

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          Most cited references168

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          IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045

          Since the year 2000, IDF has been measuring the prevalence of diabetes nationally, regionally and globally.
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            Origins and Mechanisms of miRNAs and siRNAs.

            Over the last decade, approximately 20-30 nucleotide RNA molecules have emerged as critical regulators in the expression and function of eukaryotic genomes. Two primary categories of these small RNAs--short interfering RNAs (siRNAs) and microRNAs (miRNAs)--act in both somatic and germline lineages in a broad range of eukaryotic species to regulate endogenous genes and to defend the genome from invasive nucleic acids. Recent advances have revealed unexpected diversity in their biogenesis pathways and the regulatory mechanisms that they access. Our understanding of siRNA- and miRNA-based regulation has direct implications for fundamental biology as well as disease etiology and treatment.
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              Global estimates of diabetes prevalence for 2013 and projections for 2035.

              Diabetes is a serious and increasing global health burden and estimates of prevalence are essential for appropriate allocation of resources and monitoring of trends. We conducted a literature search of studies reporting the age-specific prevalence for diabetes and used the Analytic Hierarchy Process to systematically select studies to generate estimates for 219 countries and territories. Estimates for countries without available source data were modelled from pooled estimates of countries that were similar in regard to geography, ethnicity, and economic development. Logistic regression was applied to generate smoothed age-specific prevalence estimates for adults 20-79 years which were then applied to population estimates for 2013 and 2035. A total of 744 data sources were considered and 174 included, representing 130 countries. In 2013, 382 million people had diabetes; this number is expected to rise to 592 million by 2035. Most people with diabetes live in low- and middle-income countries and these will experience the greatest increase in cases of diabetes over the next 22 years. The new estimates of diabetes in adults confirm the large burden of diabetes, especially in developing countries. Estimates will be updated annually including the most recent, high-quality data available. Copyright © 2013. Published by Elsevier Ireland Ltd.
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                Author and article information

                Contributors
                Journal
                Front Med (Lausanne)
                Front Med (Lausanne)
                Front. Med.
                Frontiers in Medicine
                Frontiers Media S.A.
                2296-858X
                30 March 2021
                2021
                : 8
                : 661076
                Affiliations
                Department of Nephrology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine , Shanghai, China
                Author notes

                Edited by: Tingting Zhao, China-Japan Friendship Hospital, China

                Reviewed by: Niansong Wang, Shanghai Jiao Tong University, China; Kun Gao, Affiliated Hospital of Nanjing University of Chinese Medicine, China

                *Correspondence: Rong Zheng zrong_md@ 123456126.com

                This article was submitted to Pathology, a section of the journal Frontiers in Medicine

                †These authors have contributed equally to this work

                Article
                10.3389/fmed.2021.661076
                8042139
                33859992
                77f54879-66b1-4b63-9239-c8aa7b18d6f6
                Copyright © 2021 Chang, Yan, Li, Liu, Zheng and Zhong.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 30 January 2021
                : 08 March 2021
                Page count
                Figures: 1, Tables: 1, Equations: 0, References: 169, Pages: 12, Words: 10188
                Funding
                Funded by: National Natural Science Foundation of China 10.13039/501100001809
                Funded by: Shanghai Shuguang Program 10.13039/501100018558
                Categories
                Medicine
                Review

                tubulointerstitial fibrosis,diabetic kidney disease,proximal tubular cell,proximal tubular,pathogenesis

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