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MINERVA MEDICA

A Journal on Internal Medicine


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Minerva Medica 2017 Nov 21

DOI: 10.23736/S0026-4806.17.05488-X

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Residual renal and cardiovascular disease risk in conventionally-treated patients with type 2 diabetes: the potential of non-traditional biomarkers and treatments related redox metabolism

Karima ZITOUNI 1, Mia STEYN 2, Kenneth A. EARLE 2, 3

1 Infection and Immunity Institute, St George’s University of London, London, UK; 2 Thomas Addison Diabetes Unit, St George’s University Hospitals NHS Foundation Trust, London, UK; 3 Institute of Medical and Biomedical Education, St George’s University of London, London, UK


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Diabetes is a leading cause of chronic kidney disease (CKD) in the developed world. Promoters of the progression of kidney disease include the traditional profile of cardiovascular risk factors. However, the development of CKD and vulnerability to end-stage renal disease (ESRD) is highly variable. Determinants of the susceptibility to ESRD may include non-traditional risk factors such as gene-environment interactions, socio-geographic factors and/or treatment strategies. We review the conflicting clinical relevance of studies implicating pathways related to oxidative stress. These pathways are strongly implicated in the phenotype of some groups of high-risk patients and could assume importance in clinical care. Recent clinical trial evidence has shown that newer glucose-lowering agents also have beneficial effects on reducing the incidence of renal dysfunction and cardiovascular events in high-risk patients. Research is required to identify which patients will benefit most from newer approaches to managing diabetes. Understanding the relationship of non-traditional risk factors to renal and cardiovascular disease could help clinicians targeting new therapeutic approaches in the management of type 2 diabetes.


KEY WORDS: Type 2 diabetes - Chronic kidney disease - Cardiovascular disease - Pathogenesis - Racial/ethnic - Endothelium - Oxidative stress - Treatment targets

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Publication History

Article first published online: November 21, 2017
Manuscript accepted: November 13, 2017
Manuscript received: November 10, 2017

Cite this article as

Zitouni K, Steyn M, Earle KA. Residual renal and cardiovascular disease risk in conventionally-treated patients with type 2 diabetes: the potential of non-traditional biomarkers and treatments related redox metabolism. Minerva Med 2017 Nov 21. DOI: 10.23736/S0026-4806.17.05488-X

Corresponding author e-mail

kearle@sgul.ac.uk