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Combination therapy with kidney protective therapies: optimizing the benefits?
Sradha Kotwal1,2, Evan Perkovic3, Vlado Perkovic1,4
1The George Institute for Global Health, UNSW, Sydney, NSW 2052, Australia.
Current Opinion in Nephrology and Hypertension
|September 28, 2023
Summary
New kidney protective agents, including SGLT-2 inhibitors and MRAs, show combined benefits for chronic kidney disease (CKD) patients, particularly those with diabetes. Further research is needed to optimize combination therapies for personalized CKD treatment.
Area of Science:
- Nephrology
- Pharmacology
- Cardiology
Background:
- Chronic kidney disease (CKD) management has advanced with new kidney-protective agents.
- Agents like SGLT-2 inhibitors, MRAs, and GLP-1RAs offer potential benefits, especially for diabetic CKD.
- This review focuses on the combined effects of these novel therapeutic agents.
Approach:
- Summarizing existing data on combination therapies for CKD.
- Evaluating the efficacy of SGLT-2 inhibitors, MRAs, and GLP-1RAs individually and in combination.
- Assessing the impact on kidney function and cardiovascular events.
Key Points:
- SGLT-2 inhibitors and MRAs individually demonstrate significant kidney and cardiovascular benefits in CKD, particularly diabetic CKD.
- Combination therapy with SGLT-2 inhibitors and MRAs appears to offer additive benefits.
- GLP-1RAs may provide additional benefits, but more research is required.
- Long-term data on combination therapies are still needed.
Conclusions:
- Current evidence suggests that combining SGLT-2 inhibitors and MRAs is likely beneficial for CKD patients.
- Combination therapy may represent an appropriate long-term strategy for managing CKD.
- Personalized treatment strategies through further research into optimal combinations are crucial for improving CKD outcomes.
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