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The Diabetic Kidney pp 23–36Cite as

Altered Renal Microvascular Function in Early Diabetes

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Part of the book series: Contemporary Diabetes ((CDI))

Abstract

The early stage of type 1 diabetes (T1D) is characterized by glomerular hyperfiltration that arises as the result of preglomerular (primarily afferent arteriolar) vasodilation. Although hyperglycemia is the trigger for this process, the mechanism linking hyperglycemia to reduced afferent arteriolar tone remains an area of active debate. It is well established that diabetic hyperglycemia provokes a condition of oxidative stress in many organs including the kidney. In this chapter, we consider the possible role of oxidative stress in producing a defect in afferent arteriolar electromechanical coupling that involves K+ channel activation, membrane hyperpolarization, and a consequent decrease in Ca2+ influx through voltage-gated channels. As voltage-dependent Ca2+ influx is a primary determinant of afferent (but not efferent) arteriolar tone and vasoconstrictor responsiveness, this scenario offers a potential mechanism whereby hyperglycemia results in the preglomerular vasodilation that underlies diabetic hyperfiltration.

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Authors and Affiliations

  1. Department of Cellular and Integrative Physiology, University of Nebraska College of Medicine, Omaha, NE

    Pamela K. Carmines MD

  2. Department of Medicine, Loyola University Stritch School of Medicine, Chicago, IL

    Joseph P. Bast MD

  3. Department of Hematological Informatics, Kitasato University School of Allied Health Sciences, Kanagawa, Japan

    Naohito Ishii PhD

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  1. Pamela K. Carmines MD
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  2. Joseph P. Bast MD
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  3. Naohito Ishii PhD
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Editors and Affiliations

  1. Division of Nephrology and Hypertension, Department of Medicine, Henry Ford Hospital, Detroit, MI

    Pedro Cortes MD

  2. Department of Internal Medicine M (Diabetes and Endocrinology), Aarhus University Hospital, Aarhus, Denmark

    Carl Erik Mogensen MD

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Carmines, P.K., Bast, J.P., Ishii, N. (2006). Altered Renal Microvascular Function in Early Diabetes. In: Cortes, P., Mogensen, C.E. (eds) The Diabetic Kidney. Contemporary Diabetes. Humana Press. https://doi.org/10.1007/978-1-59745-153-6_2

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  • DOI: https://doi.org/10.1007/978-1-59745-153-6_2

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