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Updated: Oct 2, 2025

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Diabetes and the kidney.

Tahseen A Chowdhury1, Omer Ali2

  • 1The Royal London Hospital, London, UK tahseen.chowdhury@nhs.net.

Clinical Medicine (London, England)
|February 22, 2022
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Summary
This summary is machine-generated.

Sodium-glucose transporter-2 inhibitors and glucagon-like peptide-1 receptor agonists offer significant benefits for diabetic kidney disease (DKD). This guidance addresses glucose management in patients with DKD, including those on renal replacement therapy.

Keywords:
diabetesdialysisnephropathysodium-glucose transporter-2transplantation

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Area of Science:

  • Nephrology
  • Endocrinology
  • Pharmacology

Background:

  • Diabetes is a leading cause of end-stage kidney disease.
  • Diabetic kidney disease (DKD) management requires specialized therapeutic approaches.
  • Patients undergoing renal replacement therapy present unique challenges in diabetes management.

Purpose of the Study:

  • To provide guidance on glucose management in patients with diabetic kidney disease (DKD).
  • To outline therapeutic considerations for patients with DKD, including those on renal replacement therapy.
  • To summarize the role of novel pharmacotherapies in DKD management.

Main Methods:

  • Review of randomized controlled trials on sodium-glucose transporter-2 inhibitors in DKD.
  • Analysis of studies evaluating glucagon-like peptide-1 receptor agonists for albuminuria reduction in DKD.
  • Synthesis of current guidelines for diabetes management in renal replacement therapy patients.

Main Results:

  • Sodium-glucose transporter-2 inhibitors demonstrate significant benefits in DKD patients.
  • Glucagon-like peptide-1 receptor agonists show efficacy in reducing albuminuria progression.
  • Current guidelines recommend considering these agents irrespective of glycemic control.

Conclusions:

  • Sodium-glucose transporter-2 inhibitors and GLP-1 receptor agonists are crucial in DKD management.
  • Early consideration of these agents is advised in the therapeutic pathway.
  • Specific guidance is needed for managing diabetes in patients on dialysis or transplantation.