| Literature DB >> 32267078 |
Jeffrey W Stephens1, Karen E Brown1, Thinzar Min1.
Abstract
This review examines the current literature relating to diabetes related kidney disease (DKD) and the optimal management of cardio-renal risk. DKD develops in approximately 40% of patients with type 2 diabetes mellitus. The mainstay of therapy is to reduce the progression of DKD by optimising hyperglycaemia, blood pressure, lipids and lifestyle. Evidence supports the role for renin-angiotensin system blockade in limiting the progression of DKD. Recent data from diabetes related cardiovascular outcome trials and renal specific trials have provided a novel insight on the additional benefits of sodium-glucose cotransporter-2 inhibitors (SGLT2i) in reducing the progression of DKD as well as cardiovascular risk. Lessons have been learnt from CREDENCE and there are expectations that DAPA-CKD and EMPA-KIDNEY will further support the benefits of SGLT2 inhibition in relation to DKD. As a consequence, international guidelines have been updated to reflect the positive benefits. In addition, novel steroidal mineralocorticoid receptor antagonists offer a potential role in future years. The review examines the current evidence and future approach to optimising outcomes for renal protection in patients with diabetes.Entities:
Keywords: angiotensin II receptor blockers; angiotensin-converting enzyme inhibitors; chronic kidney disease; diabetes-related nephropathy; diabetic nephropathy; dipeptidyl peptidase-4 (DPP-4) inhibitors; glucagon like peptide-1 receptor agonists; sodium-glucose cotransporter-2 inhibitors; type 2 diabetes
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Year: 2020 PMID： 32267078 DOI： 10.1111/dom.13942
Source DB: PubMed Journal: Diabetes Obes Metab ISSN： 1462-8902 Impact factor: 6.577