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[Renal effects of GLP-1 agonists in type 2 diabetes]

Alicia Elbert1, Carlos Castellaro2, Leon Litwak3

  • 1Centro de Enfermedades Renales e Hipertensión Arterial, Avellaneda, Argentina.

Medicina
|July 29, 2022
PubMed

Insights

Type 2 diabetes is rising, impacting health. Glucagon-like peptide-1 (GLP-1) receptor agonists offer significant renal protection beyond blood sugar control, as shown in clinical studies.

Area of Science:

  • Endocrinology
  • Nephrology
  • Cardiology

Background:

  • Rising prevalence of type 2 diabetes mellitus (DM2) poses significant individual and public health challenges.
  • Impaired renal function affects nearly half of DM2 patients, highlighting the critical need for nephron-protection strategies.
  • Therapeutic focus has shifted to cardio-renal metabolic therapy, incorporating agents with cardiovascular and renal benefits into guidelines.

Purpose of the Study:

  • To review the direct and indirect effects of glucagon-like peptide-1 (GLP-1) receptor agonists on renal function in type 2 diabetes.
  • To summarize evidence from pivotal clinical trials and real-world studies demonstrating the renal benefits of GLP-1 receptor agonists.
  • To discuss the multifactorial mechanisms of renal protection offered by these agents, extending beyond glycemic control.

Main Methods:

  • Comprehensive literature review of clinical studies, including pivotal trials (LEADER, SUSTAIN 6, REWIND) and real-life data.
  • Analysis of evidence on the efficacy and safety of GLP-1 receptor agonists concerning renal outcomes.
  • Examination of studies evaluating cardiovascular outcomes and real-world effectiveness.

Main Results:

  • GLP-1 receptor agonists demonstrate favorable effects on renal function in patients with type 2 diabetes.
  • Evidence from clinical trials and real-world studies supports the nephroprotective potential of these agents.
  • Benefits extend beyond glycemic control, suggesting multifactorial mechanisms contributing to renal protection.

Conclusions:

  • GLP-1 receptor agonists represent a valuable therapeutic option for managing type 2 diabetes, offering significant renal protective benefits.
  • The evidence supports the integration of GLP-1 receptor agonists into treatment strategies to mitigate diabetic kidney disease progression.
  • Ongoing studies with renal endpoints are expected to further elucidate the long-term renal benefits of these agents.
Keywords:
GLP-1 receptor agonistsrenal outcomestype 2 diabetes mellitus

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