ReviewDiabetologia2008
What is the mechanism of microalbuminuria in diabetes: a role for the glomerular endothelium?
Review in Diabetologia, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 160 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
160 citing papers in PubMed, 360 citations in OpenAlex.
- Mineralocorticoid receptor antagonism in diabetes reduces albuminuria by preserving the glomerular endothelial glycocalyx.JCI insight · 2023Trial
- Linagliptin and its effects on hyperglycaemia and albuminuria in patients with type 2 diabetes and renal dysfunction: the randomized MARLINA-T2D trial.Diabetes, obesity & metabolism · 2017Trial
- Trial
- Urine miRNAs: potential biomarkers for monitoring progression of early stages of diabetic nephropathy.Medical hypotheses · 2013Trial
- T/L-type calcium channel blocker reduces the composite ranking of relative risk according to new KDIGO guidelines in patients with chronic kidney disease.BMC nephrology · 2013Trial
- Albuminuria and rapid loss of GFR and risk of new hip and pelvic fractures.Clinical journal of the American Society of Nephrology : CJASN · 2013Trial
- Urinary Biomarkers for the Risk Assessment and Management of Heart Failure: Pearls and Pitfalls.Current heart failure reports · 2026Review
- Canagliflozin Alleviates Diabetic Glomerular Endothelial Injury via Melibiose in a Microbiota-Dependent Manner.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026Article
- Podocyte-derived endothelin-1 and endothelial cell endothelin A receptors are essential for glomerular injury in mouse models of focal segmental glomerulosclerosis.Kidney international · 2026Article
- Sex-specific correlates of microalbuminuria in high-risk adults: a cross-sectional study.BMC research notes · 2026Article
- Transcriptomic Profiling Combined with Machine Learning and Mendelian Randomization Identifies Diagnostic Biomarkers and Immune Infiltration Patterns in Diabetic Kidney Disease.Molecules (Basel, Switzerland) · 2026Article
- Longitudinal association between early-life famine exposure and risk of microvascular complications of type 2 diabetes in adulthood: A retrospective cohort in Tianjin, China.Asia Pacific journal of clinical nutrition · 2026Article
- The glomerular endothelial glycocalyx as a therapeutic target in proteinuric kidney disease.Nature reviews. Nephrology · 2026Review
- Article
- Gene modification: Exploring the potential in treating kidney diseases.Pharmacological research · 2026Review
- Podocyte-directed VEGFC gene therapy prevents increased glomerular permeability and glycocalyx damage in experimental type 1 diabetes.Molecular therapy : the journal of the American Society of Gene Therapy · 2026Article
- Non-diabetic Kidney Disease in Type 2 Diabetes: From Kidney Biopsy to Precision Medicine.Cureus · 2026Review
- Research on a Predictive Model for Microalbuminuria in Type 2 Diabetes Based on Machine Learning and SHAP Analysis.International journal of endocrinology · 2026Article
- Mitochondrial dysfunction: the hidden catalyst in chronic kidney disease progression.Renal failure · 2025Review
- Logic-based modeling of inflammatory macrophage cross talk with glomerular endothelial cells in diabetic kidney disease.American journal of physiology. Renal physiology · 2025Article
100 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 2 institutions in 1 country.
Funding
Abstract
Microalbuminuria is an important risk factor for cardiovascular disease and progressive renal impairment. This holds true in the general population and particularly in those with diabetes, in whom it is common and marks out those likely to develop macrovascular disease and progressive renal impairment. Understanding the pathophysiological mechanisms through which microalbuminuria occurs holds the key to designing therapies to arrest its development and prevent these later manifestations. Microalbuminuria arises from the increased passage of albumin through the glomerular filtration barrier. This requires ultrastructural changes rather than alterations in glomerular pressure or filtration rate alone. Compromise of selective glomerular permeability can be confirmed in early diabetic nephropathy but does not correlate well with reported glomerular structural changes. The loss of systemic endothelial glycocalyx--a protein-rich surface layer on the endothelium--in diabetes suggests that damage to this layer represents this missing link. The epidemiology of microalbuminuria reveals a close association with systemic endothelial dysfunction and with vascular disease, also implicating glomerular endothelial dysfunction in microalbuminuria. Our understanding of the metabolic and hormonal sequelae of hyperglycaemia is increasing, and we consider these in the context of damage to the glomerular filtration barrier. Reactive oxygen species, inflammatory cytokines and growth factors are key players in this respect. Taken together with the above observations and the presence of generalised endothelial dysfunction, these considerations lead to the conclusion that glomerular endothelial dysfunction, and in particular damage to its glycocalyx, represents the most likely initiating step in diabetic microalbuminuria.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.