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NDT Advance Access originally published online on July 20, 2008
Nephrology Dialysis Transplantation 2008 23(10):3047-3049; doi:10.1093/ndt/gfn377
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


Activation of the renal renin–angiotensin system in diabetes—new concepts

János Peti-Peterdi, Jung Julie Kang and Ildiko Toma

Departments of Physiology and Biophysics and Medicine, Zilkha Neurogenetic Institute, University of Southern California, Los Angeles, CA 90033, USA

János Peti-Peterdi, Zilkha Neurogenetic Institute, University of Southern California, 1501 San Pablo Street, ZNI 335, Los Angeles, CA 90033, USA. Tel: +1-323-442-4337; Fax: +1-323-442-4466; E-mail: petipete@usc.edu

Keywords: collecting duct; diabetic nephropathy; GPR91; prorenin; succinate

The first 10% of the full text of this article appears below.



   Background
 
The incidence of diabetes mellitus, obesity and the metabolic syndrome is rapidly rising to epidemic levels worldwide. Hyperglycemia, the metabolic hallmark of the pathology, is a significant causative factor for the complications of diabetes mellitus which result in significant morbidity and mortality for millions. Hyperglycemia is clearly associated with microvascular complications in many organs including the kidney, and diabetic nephropathy is the leading cause of end-stage renal disease (ESRD) in developed countries [1,2]. In addition, diabetes may lead to other vascular complications, including systemic hypertension [1,2]. Recent advances on the cellular and kidney-specific effects of hyperglycemia place activation of the local, intra-renal renin–angiotensin system (RAS) as a strong candidate for the core abnormality that leads to renal tissue injury [1–3].

The nature of RAS activation in diabetes is, however, controversial [3]. It has been . . . [Full Text of this Article]



   Succinate and GPR91 directly link high glucose levels to JGA renin release
 


   In vivo imaging of (pro)renin
 


   The distal nephron is the major source of (pro)renin in diabetes
 


   Conclusion
 

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