Luxcia Kugathasan, Yarden Aronson, Vikas S Sridhar, Huajing Ni, Jean-Phillipe Ouimet, Christine P Limonte, Shohinee Sarma, David Z I Cherney
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引用次数: 0
Abstract
Introduction: For decades, the first-line treatment for kidney protection in people with type 1 diabetes (T1D) and chronic kidney disease (CKD) has been limited to intensive glycemic control, renin-angiotensin system blockers and managing modifiable risk factors. Accordingly, risk of CKD progression has remained unacceptably high, emphasizing the need for novel kidney protective therapies in T1D.
Areas covered: This review summarizes the recent evidence supporting the use of existing treatments used for kidney protection in people with type 2 diabetes (T2D) for potential repurposing for people with T1D. First, we highlight the putative structural and functional changes that actively contribute to CKD progression and highlight key hemodynamic, pro-inflammatory, and kidney injury risk markers in T1D. Next, we discuss emerging nephroprotective therapies targeting these pathophysiological factors, review mechanistic studies that have assessed kidney benefits of these agents in T1D, and highlight ongoing kidney-focused trials in T1D, including SUGARNSALT (NCT06217302), FINE-ONE (NCT05901831) and REMODEL-T1D (NCT05822609).
Expert opinion: Several medications have become available that could potentially transform CKD care in T1D. It is essential to devise strategies that could address the treatment landscape for kidney protection in T1D by assessing the risk-benefit calculus and expanding the nephrologist's toolkit for minimizing kidney risk in T1D.
期刊介绍：
Expert Review of Clinical Immunology (ISSN 1744-666X) provides expert analysis and commentary regarding the performance of new therapeutic and diagnostic modalities in clinical immunology. Members of the International Editorial Advisory Panel of Expert Review of Clinical Immunology are the forefront of their area of expertise. This panel works with our dedicated editorial team to identify the most important and topical review themes and the corresponding expert(s) most appropriate to provide commentary and analysis. All articles are subject to rigorous peer-review, and the finished reviews provide an essential contribution to decision-making in clinical immunology.
Articles focus on the following key areas:
• Therapeutic overviews of specific immunologic disorders highlighting optimal therapy and prospects for new medicines
• Performance and benefits of newly approved therapeutic agents
• New diagnostic approaches
• Screening and patient stratification
• Pharmacoeconomic studies
• New therapeutic indications for existing therapies
• Adverse effects, occurrence and reduction
• Prospects for medicines in late-stage trials approaching regulatory approval
• Novel treatment strategies
• Epidemiological studies
• Commentary and comparison of treatment guidelines
Topics include infection and immunity, inflammation, host defense mechanisms, congenital and acquired immunodeficiencies, anaphylaxis and allergy, systemic immune diseases, organ-specific inflammatory diseases, transplantation immunology, endocrinology and diabetes, cancer immunology, neuroimmunology and hematological diseases.
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