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Primary kidney growth and its consequences at the onset of diabetes mellitus

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Summary.

Diabetes mellitus is a primary contributor to progressive kidney dysfunction leading to end-stage renal disease (ESRD). In the early phase of diabetes, prior to the onset of further complications, both kidney size and glomerular filtration rate (GFR) increase. Glomerular hyperfiltration is considered a risk factor for downstream complications and progression to ESRD. Abnormalities in vascular control have been purported to account for the glomerular hyperfiltration in early diabetes. In this review we discuss a tubulo-centric concept in which tubular growth and subsequent hyper-reabsorption contribute to the onset of glomerular hyperfiltration that demarks the early stage of diabetes. Kidney growth, in this concept, is no longer relegated to a compensatory response to hyperfiltration, but rather plays a primary and active role in its genesis and progression. As such, components of kidney growth, such as the polyamines, may provide a means of early detection of diabetic kidney dysfunction and more effective therapeutic intervention.

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Authors and Affiliations

  1. Department of Medicine, Division of Nephrology-Hypertension, The Veterans Administration San Diego Healthcare System, University of California, San Diego, CA, U.S.A.

    J. Satriano & V. Vallon

  2. Department of Pharmacology, University of San Diego, San Diego, CA, U.S.A.

    V. Vallon

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  1. J. Satriano
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  2. V. Vallon
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Satriano, J., Vallon, V. Primary kidney growth and its consequences at the onset of diabetes mellitus. Amino Acids 31, 1–9 (2006). https://doi.org/10.1007/s00726-006-0326-x

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