Role of Zinc in Diabetic Kidney Disease

Abstract

Diabetic Kidney Disease (DKD) represents the most common cause of Chronic Kidney Disease (CKD) in developed countries. Approximately 30% to 40% of diabetes mellitus (DM) subjects develop DKD, and its presence significantly increases the risk for morbidity and mortality. In this context, Zinc seems to have a potential role in kidney and body homeostasis in diabetic individuals as well as in patients at a high risk of developing this condition. This essential element has functions that may counteract diabetes-related risk factors and complications, which include stabilization of insulin hexamers and pancreatic insulin storage and improved glycemic control. In our review, we analyzed the current knowledge on the role of zinc in the management of renal impairment in course of DM. Several studies underline the critical role of zinc in reducing oxidative stress levels, which is considered the common denominator of the mechanisms responsible for the progression of kidney disease. Reaching and maintaining a proper serum zinc level could represent a valuable target to reduce symptoms related to DM complications and contrast the progression of kidney impairment in patients with the high risk of developing end-stage renal disease. In conclusion, analyzing the beneficial role of zinc in this review would advance our knowledge on the possible strategies of DM and DKD treatment.

Keywords: antioxidant agent; chronic kidney disease; diabetes mellitus; diabetic kidney disease; diabetic nephropathy; zinc.

Figure 1

Zinc-related mechanisms in body homeostasis. AR, aldose reductase; CASP3, caspase 3; CASP9, caspase 9; CTGF, connective tissue growth factor; Cys-C, C-Cytochrome; HIF1, hypoxia inducible factor; MT, metallothionine; Nrf2, nuclear factor-erythroid 2-related factor 2; ROS, reactive oxygen species; SDH, sorbitol dehydrogenase; α-SMA, α-smooth muscle.