Cardiovascular outcomes in diabetic kidney disease: insights from recent clinical trials

IF 19.3 2区医学 Q1 UROLOGY & NEPHROLOGY

Kidney International Supplements Pub Date : 2018-01-01 DOI:10.1016/j.kisu.2017.10.004

Natalia A. Rocha , Peter A. McCullough

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引用次数: 8

Abstract

The prevalence of type 2 diabetes is catalyzing a pandemic in kidney disease, with ensuing cardiovascular complications. The effort to identify antidiabetic agents capable of promoting benefits that go beyond the bounds of glucose control has produced remarkable outcomes in recent cardiovascular outcomes trials in patients with type 2 diabetes mellitus, many of whom have diabetic kidney disease. Two novel antidiabetic drug classes, sodium–glucose cotransporter 2 inhibitors (SGLT2is) and glucagon-like peptide-1 receptor agonists (GLP-1 RAs), improve cardiovascular outcomes in different ways, with SGLT2is reducing the risk of heart failure and cardiovascular death and GLP-1 RAs being associated with reduced risk of myocardial infarction and cardiovascular death. Further mechanistic studies and additional cardiovascular outcome trials are ongoing and are expected to determine whether these benefits are a result of class effect, as well as to delineate optimum timing for intervention and population target.

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糖尿病肾病的心血管结局:来自近期临床试验的见解

2型糖尿病的流行正在催化肾脏疾病的大流行，随之而来的是心血管并发症。在最近针对2型糖尿病患者(其中许多患有糖尿病肾病)的心血管预后试验中，发现能够促进超出血糖控制范围的益处的抗糖尿病药物的努力取得了显著的结果。两种新型降糖药物，钠-葡萄糖共转运蛋白2抑制剂(SGLT2is)和胰高血糖素样肽-1受体激动剂(GLP-1 RAs)，以不同的方式改善心血管结局，SGLT2is降低心力衰竭和心血管死亡的风险，GLP-1 RAs与降低心肌梗死和心血管死亡的风险相关。进一步的机制研究和额外的心血管结局试验正在进行中，预计将确定这些益处是否是类别效应的结果，以及描述最佳干预时间和人群目标。

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来源期刊

Kidney International Supplements UROLOGY & NEPHROLOGY-

CiteScore

11.80

自引率

0.00%

发文量

期刊介绍： Kidney International Supplements is published on behalf of the International Society of Nephrology (ISN) and comes complimentary as part of a subscription to Kidney International. Kidney International Supplements is a peer-reviewed journal whose focus is sponsored, topical content of interest to the nephrology community.