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Diabetic kidney disease treatment: new perspectives
1Division of Nephrology and Hypertension, The Lundquist Institute, Harbor-UCLA Medical Center, Torrance, CA, USA.
Kidney Research and Clinical Practice
|October 14, 2022
Summary
Diabetic kidney disease (DKD) management is advancing with new therapies. Combining renin-angiotensin system inhibitors with SGLT2 inhibitors, GLP-1 receptor agonists, and MRAs offers improved outcomes for type 2 diabetes patients.
Area of Science:
- Nephrology
- Endocrinology
- Cardiology
Background:
- Diabetic kidney disease (DKD) is a primary cause of chronic and end-stage kidney disease globally.
- Rising obesity and diabetes rates exacerbate the DKD burden worldwide.
- Current guidelines recommend lifestyle changes, blood pressure and glycemic control, and lipid management.
Purpose of the Study:
- To review current and emerging therapeutic strategies for managing diabetic kidney disease (DKD) in type 2 diabetes (T2D).
- To highlight the expanded treatment options for DKD and its cardiovascular complications.
Main Methods:
- Review of current guideline-recommended therapies for DKD.
- Discussion of novel pharmacological agents including SGLT2 inhibitors, GLP-1 RA, and nonsteroidal MRAs.
- Emphasis on combination therapy approaches for T2D with DKD.
Main Results:
- Renin-angiotensin system (RAS) inhibition remains a cornerstone therapy for DKD.
- Newer agents like SGLT2 inhibitors, GLP-1 RAs, and finerenone significantly expand treatment options.
- Combination therapy (RAS inhibitor + SGLT2i/GLP-1 RA + nonsteroidal MRA + statin) shows promise for improved patient outcomes.
Conclusions:
- Optimizing pharmacological therapy with a combination of agents is crucial for managing T2D with DKD.
- Emerging research into novel therapeutic targets offers optimism for future DKD treatment.
- A multi-faceted approach combining foundational and novel therapies can significantly improve outcomes.
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