Cardiorenal Protection in Diabetic Kidney Disease.

Endocrinology and metabolism (Seoul, Korea) Pub Date : 2021-04-01 Epub Date: 2021-04-19 DOI:10.3803/EnM.2021.987

Jason F Lee, Ecaterina Berzan, Vikas S Sridhar, Ayodele Odutayo, David Z I Cherney

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引用次数: 8

Abstract

Over the last 5 years there have been many new developments in the management of diabetic kidney disease. Glucagon-like peptide-1 receptor agonists (GLP-1 RA) and sodium-glucose cotransporter-2 (SGLT2) inhibitors were initially used for glycemic control, but more recent studies have now shown that their benefits extend to cardiovascular and kidney outcomes. The recent addition of data on the novel mineralocorticoid receptor antagonist (MRA) gives us another approach to further decrease the residual risk of diabetic kidney disease progression. In this review we describe the mechanism of action, key studies, and possible adverse effects related to these three classes of medications. The management of type 2 diabetes now includes an increasing number of medications for the management of comorbidities in a patient population at significant risk of cardiovascular disease and progression of chronic kidney disease. It is from this perspective that we seek to outline the rationale for the sequential and/or combined use of SGLT2 inhibitors, GLP-1 RA and MRAs in patients with type 2 diabetes for heart and kidney protection.

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糖尿病肾病的心肾保护。

在过去的5年里，糖尿病肾病的治疗有了许多新的进展。胰高血糖素样肽-1受体激动剂(GLP-1 RA)和钠-葡萄糖共转运体-2 (SGLT2)抑制剂最初用于血糖控制，但最近的研究表明它们的益处扩展到心血管和肾脏结局。最近增加的关于新型矿皮质激素受体拮抗剂(MRA)的数据为我们提供了另一种进一步降低糖尿病肾病进展的剩余风险的方法。在这篇综述中，我们描述了这三类药物的作用机制、关键研究和可能的不良反应。目前，2型糖尿病的治疗包括越来越多的药物，用于治疗心血管疾病和慢性肾脏疾病进展风险较高的患者群体的合并症。正是从这个角度出发，我们试图概述在2型糖尿病患者中顺序和/或联合使用SGLT2抑制剂、GLP-1 RA和MRAs来保护心脏和肾脏的基本原理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Endocrinology and metabolism (Seoul, Korea)

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