Related Experiment Video

Updated: Aug 7, 2026

Comparative Proteomic Analysis of Whole Kidney, Medulla, and Cortical Tubules in Diabetic Pathogenesis of Kidney Injury in Mice
10:31

Comparative Proteomic Analysis of Whole Kidney, Medulla, and Cortical Tubules in Diabetic Pathogenesis of Kidney Injury in Mice

Published on: May 2, 2025

Targeting kidney disease in type 1 diabetes: progress and promise

Marcel H A Muskiet1,2, David Z I Cherney2

  • 1Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands.

Expert Review of Endocrinology & Metabolism
|August 6, 2026
PubMed

Insights

New therapies like SGLT-inhibitors and GLP-1 agonists show promise for protecting kidneys in type-1 diabetes (T1D). This review explores evidence for these treatments, addressing a critical gap in T1D chronic kidney disease (CKD) management.

Area of Science:

  • Nephrology
  • Endocrinology
  • Diabetology

Background:

  • Chronic kidney disease (CKD) affects 30-40% of type-1 diabetes (T1D) patients, driving significant morbidity and mortality.
  • Current T1D kidney protection relies on older renin-angiotensin-system (RAS) inhibition, unlike the advanced treatments available for type-2 diabetes (T2D).
  • A critical evidence gap exists for T1D due to exclusion from pivotal trials of newer therapies.

Purpose of the Study:

  • To review mechanistic and clinical evidence for a paradigm shift in kidney protection for T1D.
  • To evaluate the renoprotective potential and safety of SGLT-inhibitors, GLP-1-based therapies, and finerenone in T1D.
  • To highlight the evolving T1D phenotype and its implications for therapeutic strategies.

Main Methods:

  • Comprehensive literature searches of major databases (PubMed/MEDLINE, Embase, Web of Science) and ClinicalTrials.gov.
  • Analysis of ongoing studies through March 2026.
  • Critical evaluation of current standards-of-care, unmet needs, and emerging therapeutic agents.

Main Results:

  • The evolving T1D phenotype, including rising obesity and cardiometabolic dysfunction, strengthens the rationale for therapeutic translation.
  • Emerging evidence supports the potential of SGLT-inhibitors, GLP-1-based therapies, and finerenone for renoprotection in T1D.
  • Albuminuria is identified as a key bridging biomarker for regulatory translation.

Conclusions:

  • CKD management in T1D is poised for significant therapeutic advancements.
  • Ongoing trials, novel strategies, validated endpoints, precision medicine, and multidisciplinary care are crucial for modifying CKD trajectories in T1D.
  • A paradigm shift towards more effective kidney protection in T1D is anticipated.
Abstract

Keywords:
GLP-1 receptor agonistsSGLT inhibitorsType 1 diabetescardiorenal therapeuticschronic kidney diseasefinerenonemulti-hormone receptor modulators

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