Nephrol Dial Transplant (2004) 19: 778-781
Nephrol Dial Transplant Vol. 19 No. 4 © ERA-EDTA 2004; all rights reserved
Editorial Comment
Endothelial dysfunction in diabetic nephropathy: state of the art and potential significance for non-diabetic renal disease
VU University Medical Center, Amsterdam, The Netherlands
Correspondence and offprint requests to: Coen D. A. Stehouwer, Professor of Medicine, VU University Medical Center, 1081 HV Amsterdam, The Netherlands. Email: cda.stehouwer@vumc.nl
Keywords: diabetes; endothelial dysfunction; microalbuminuria; renal disease
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An epidemic of diabetic nephropathy and cardiovascular disease |
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Much of the disease burden in diabetes occurs in patients with diabetic nephropathy, as they have the highest chance of developing cardiovascular disease as well as severe retinopathy and neuropathy [1]. Two issues appear crucial in stemming the epidemic of diabetic nephropathy and cardiovascular disease. One is the prevention of diabetes and the solution here from a public health point of view lies in the prevention of obesity. The other is improved understanding of the pathogenesis of renal and vascular disease in diabetes. Here, endothelial dysfunction (ED) is thought to play a key role. What is the state of the art with regard to this hypothesis?
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Endothelial dysfunction: the concept |
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The endothelium is an important site of control of vascular functions [2]. Vascular endothelium normally decreases vascular tone; limits leukocyte adhesion and, thus, inflammatory activity in the vessel wall; regulates vascular permeability to nutrients, macromolecules and leukocytes; inhibits platelet adhesion
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Endothelial dysfunction: ready for clinical use? |
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Does endothelial dysfunction cause (micro)albuminuria? |
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When does endothelial dysfunction occur in diabetes? |
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Can endothelial dysfunction cause type 2 diabetes? |
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Conclusions |
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