ReviewKidney international2020
The role of renal hypoxia in the pathogenesis of diabetic kidney disease: a promising target for newer renoprotective agents including SGLT2 inhibitors?
Review in Kidney international, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 104 papers, 1 of them a synthesis that pooled it.
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Who cites it
104 citing papers in PubMed, 1 synthesis or guideline pooled it, 178 citations in OpenAlex.
- Refractory IgA Nephropathy: A Challenge for Future Nephrologists.Medicina (Kaunas, Lithuania) · 2024Pooled it
- Multi-Parametric Magnetic Resonance Imaging to Assess Empagliflozin Effect on the Kidneys in People With Type 2 Diabetes Mellitus: A Pilot Clinical Trial.Diabetes, obesity & metabolism · 2026Trial
- Effect of empagliflozin on urinary albumin excretion and hypoxic biomarkers in early diabetic kidney disease: A randomised double-blind, placebo-controlled trial.Diabetes, obesity & metabolism · 2026Trial
- Separate and combined effects of semaglutide and empagliflozin on kidney oxygenation and perfusion in people with type 2 diabetes: a randomised trial.Diabetologia · 2023Trial
- Plasma levels of carboxylic acids are markers of early kidney dysfunction in young people with type 1 diabetes.Pediatric nephrology (Berlin, Germany) · 2023Trial
- Association between extracellular-to-total body water ratio and eGFR decline in diabetic kidney disease: a longitudinal cohort study.Clinical and experimental nephrology · 2026Observational
- Natural product therapy in diabetic kidney disease: emerging multiomics-mediated signalling pathway and molecular target.Chinese medicine · 2026Review
- Multiparametric MRI for Early Chronic Kidney Disease Detection: Insights Into Renal Microcirculation.NMR in biomedicine · 2026Article
- Silymarin attenuates diabetic nephropathy in rats via modulation of the miRNA-223/NLRP3/caspase-1/GSDMD axis and inflammasome-related pyroptotic signaling.Biology direct · 2026Article
- Article
- Multimodal Magnetic Resonance Imaging in Diabetic Kidney Disease: From Pathophysiological Insights to Clinical Applications.Diagnostics (Basel, Switzerland) · 2026Review
- Next-generation therapeutics for diabetic kidney disease.Nature reviews. Nephrology · 2026Review
- Hypoxia inducible factor network reflects kidney disease progression in diabetes and sodium-glucose co-transporters inhibition.Signal transduction and targeted therapy · 2026Article
- Clinical utility of BOLD-MRI in accurate diagnosis and prognostic evaluation of diabetic nephropathy: a prospective renal biopsy-based cohort study.Insights into imaging · 2026Article
- Three-dimensional pseudo-continuous arterial spin labeling magnetic resonance imaging: an effective imaging technique for early-stage kidney injury in patients with type 2 diabetes.Quantitative imaging in medicine and surgery · 2026Article
- Residual Renal Risk in Diabetic Nephropathy Despite Contemporary Therapies.Journal of clinical medicine · 2026Review
- Impact of diabetes mellitus and glucose level control on early sepsis-associated acute kidney injury: a multicenter retrospective observational study.Frontiers in medicine · 2026Article
- Zinc, type 2 diabetes, diabetic kidney disease: focus on hypoxia.Frontiers in endocrinology · 2026Review
- Impact of the longitudinal evolution of impaired fasting glucose on cardio-kidney-metabolic multimorbidity.Frontiers in endocrinology · 2026Article
- Article
44 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
7 authors at 6 institutions in 2 countries.
Funding
Abstract
Diabetic kidney disease is the most common cause of end-stage kidney disease and poses a major global health problem. Finding new, safe, and effective strategies to halt this disease has proven to be challenging. In part that is because the underlying mechanisms are complex and not fully understood. However, in recent years, evidence has accumulated suggesting that chronic hypoxia may be the primary pathophysiological pathway driving diabetic kidney disease and chronic kidney disease of other etiologies and was called the chronic hypoxia hypothesis. Hypoxia is the result of a mismatch between oxygen delivery and oxygen demand. The primary determinant of oxygen delivery is renal perfusion (blood flow per tissue mass), whereas the main driver of oxygen demand is active sodium reabsorption. Diabetes mellitus is thought to compromise the oxygen balance by impairing oxygen delivery owing to hyperglycemia-associated microvascular damage and exacerbate oxygen demand owing to increased sodium reabsorption as a result of sodium-glucose cotransporter upregulation and glomerular hyperfiltration. The resultant hypoxic injury creates a vicious cycle of capillary damage, inflammation, deposition of the extracellular matrix, and, ultimately, fibrosis and nephron loss. This review will frame the role of chronic hypoxia in the pathogenesis of diabetic kidney disease and its prospect as a promising therapeutic target. We will outline the cellular mechanisms of hypoxia and evidence for renal hypoxia in animal and human studies. In addition, we will highlight the promise of newer imaging modalities including blood oxygenation level-dependent magnetic resonance imaging and discuss salutary interventions such as sodium-glucose cotransporter 2 inhibition that (may) protect the kidney through amelioration of renal hypoxia.
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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.