Related Experiment Video
Updated: Aug 7, 2026
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
Summary
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 and other treatments, addressing a critical gap in T1D kidney care.
Area of Science:
- Nephrology
- Endocrinology
- Cardiology
Background:
- Chronic kidney disease (CKD) affects 30-40% of type-1 diabetes (T1D) patients, leading to significant morbidity and mortality.
- Current T1D kidney protection relies on renin-angiotensin-system (RAS) inhibition, unchanged for over 30 years.
- Type-2 diabetes (T2D) treatments like SGLT-inhibitors and GLP-1 therapies have transformed CKD management, but T1D patients were excluded from trials.
Purpose of the Study:
- To review mechanistic and clinical evidence for a paradigm shift in kidney protection for T1D.
- To evaluate the evolving T1D phenotype, including rising obesity and cardiometabolic dysfunction.
- To assess the renoprotective potential and safety of novel therapies in T1D.
Main Methods:
- Comprehensive literature search of PubMed/MEDLINE, Embase, Web of Science, and ClinicalTrials.gov.
- Analysis of ongoing studies through March 2026.
- Critical evaluation of current standards-of-care and unmet needs in T1D CKD management.
Main Results:
- The evolving T1D phenotype strengthens the rationale for therapeutic translation.
- Sodium-glucose co-transporter (SGLT)-inhibitors, glucagon-like peptide (GLP)-1-based therapies, and finerenone show potential for renoprotection in T1D.
- The FINE-ONE trial and albuminuria as a biomarker are highlighted for regulatory translation.
Conclusions:
- CKD management in T1D is poised for therapeutic renewal.
- Ongoing trials, pillar strategies, and precision medicine may significantly alter CKD trajectories in T1D.
- Multidisciplinary care is crucial for optimizing CKD outcomes in T1D.
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