Interní Med. 2018; 20(1): 24-26 | DOI: 10.36290/int.2018.049

Novel antidiabetics and progression of diabetic nephropathy

MUDr. Jan Vachek, PhDr. MUDr. Oskar Zakiyanov, Ph.D., prof. MUDr. Vladimír Tesař, MBA, DrSc.
Klinika nefrologie 1. LF UK a VFN, Praha

Diabetic nephropathy (or diabetic kidney disease in the new nomenclature) is among frequent diabetes complications, particularlyin patients with worse disease control, hypertension, glomerular hyperfiltration, or genetic predispositions. Furthermore,progression of diabetic nephropathy is often associated with smoking, anaemia, and increased protein intake. At present, patientswith both type 1 and type 2 diabetes appear to have a similarly high risk of developing diabetic nephropathy. Preventionand treatment of diabetic kidney disease must be comprehensive and involves tight glycaemic control, blood pressure control(by blocking the renin-angiotensin-aldosterone system), and reduction in LDL cholesterol. Other measures include, for instance,exclusion of nephrotoxic medication. Currently, the effect of novel antidiabetics on the progression of diabetic nephropathy isbeing intensively studied; based on the findings of recent studies, empagliflozin and liraglutide lead to a significant reduction incardiovascular and renal endpoints as well as a decrease in mortality. The paper aims at providing a comprehensive overview ofthe current strategies in the prevention and treatment of diabetic nephropathy with a focus on the role of novel antidiabetics.

Keywords: diabetic nephropathy, chronic kidney disease, cardiovascular risk, empagliflozin, liraglutide

Received: November 13, 2017; Accepted: February 2, 2018; Published: March 1, 2018  Show citation

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Vachek J, Zakiyanov O, Tesař V. Novel antidiabetics and progression of diabetic nephropathy. Interní Med. 2018;20(1):24-26. doi: 10.36290/int.2018.049.
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References

  1. Ekinci EI, Jerums G, Skene A, Crammer P, Power D, Cheong KY. Renal structure in normoalbuminuric and albuminuric patients with type 2 diabetes and impaired renal function. Diabetes Care. 2013; 36(11): 3620-3626. Go to original source... Go to PubMed...
  2. Hall JE, Henegar JR, Dwyer TM, Liu J, Da Silva AA, Kuo JJ. Is obesity a major cause of chronic kidney disease?. Adv Ren Replace Ther. 2004; 11(1): 41-54. Go to original source... Go to PubMed...
  3. Yip JW, Jones SL, Wiseman MJ, Hill C, Viberti G. Glomerular hyperfiltration in the prediction of nephropathy in IDDM: a 10-year follow-up study. Diabetes. 1996; 45(12): 1729-1733. Go to original source... Go to PubMed...
  4. Suckling RJ, He FJ, Macgregor GA. Altered dietary salt intake for preventing and treating diabetic kidney disease. Cochrane Database Syst Rev. 2010 Dec 8. 12: CD006763. Go to original source... Go to PubMed...
  5. Heerspink HJ, Holtkamp FA, Parving HH, Navis GJ, Lewis JB, Ritz E, et al. Moderation of dietary sodium potentiates the renal and cardiovascular protective effects of angiotensin receptor blockers. Kidney Int. 2012 Mar 21. Go to original source... Go to PubMed...
  6. Rask-Madsen C, King GL. Kidney complications: factors that protect the diabetic vasculature. Nat Med. 2010; 16(1): 40-41. Go to original source... Go to PubMed...
  7. Shlipak M. Diabetic nephropathy. Clin Evid (Online). 2009 Jan 14. 2009:[Medline].
  8. Burney BO, Kalaitzidis RG, Bakris GL. Novel therapies of diabetic nephropathy. Curr Opin Nephrol Hypertens. 2009; 18(2): 107-111. [Medline]. Go to original source... Go to PubMed...
  9. Diabetes Control and Complications Research Group. Effect of intensive therapy on the development and progression of diabetic nephropathy in the Diabetes Control and Complications Trial. The Diabetes Control and Complications (DCCT) Research Group. Kidney Int. 1995; 47(6): 1703-1720. [Medline]. Go to original source... Go to PubMed...
  10. UK Prospective Diabetes Study Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group. Lancet. 1998; 352(9131): 837-853. [Medline]. Go to original source...
  11. Scheen AJ. Pharmacokinetic considerations for the treatment of diabetes in patients with chronic kidney disease. Expert Opin Drug Metab Toxicol. 2013; 9(5): 529-550. [Medline]. Go to original source... Go to PubMed...
  12. Bergman AJ, Cote J, Yi B, Marbury T, Swan SK, Smith W. Effect of renal insufficiency on the pharmacokinetics of sitagliptin, a dipeptidyl peptidase-4 inhibitor. Diabetes Care. 2007; 30(7): 1862-1864. [Medline]. Go to original source... Go to PubMed...
  13. Snyder RW, Berns JS. Use of insulin and oral hypoglycemic medications in patients with diabetes mellitus and advanced kidney disease. Semin Dial. 2004; 17(5): 365-370. [Medline]. Go to original source... Go to PubMed...
  14. Groop PH, Cooper ME, Perkovic V, Emser A, Woerle HJ, von Eynatten M: Linagliptin lowers albuminuria on top of recommended standard treatment in patients with type 2 diabetes and renal dysfunction. Diabetes Care. 2013; 36(11): 3460-3468. Go to original source... Go to PubMed...
  15. Wanner C, et al. "Empagliflozin and Progression of Kidney Disease in Type 2 Diabetes." NEJM. 2016; 375(4): 323-334.] Go to original source... Go to PubMed...
  16. Abdul-Ghani M et al. SGLT2 Inhibitors and Cardiovascular Risk: Lessons Learned From the EMPA-REG OUTCOME Study. Diabetes Care 2016; 39: 717-725. Go to original source... Go to PubMed...
  17. Davidson JA, Brett J, Falahati A, Scott D. Mild renal impairment and the efficacy and safety of liraglutide. Endocr Pract. 2011; 17(3): 345-355. [Medline]. Go to original source... Go to PubMed...




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