胰高血糖素样肽-1 受体激动剂与肾脏功能。

IF 3 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Richard J. MacIsaac, Philippa Trevella, Elif I. Ekinci
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引用次数: 0

摘要

胰高血糖素样肽-1 受体激动剂(GLP-1RA)因其对患有慢性肾病(CKD)的 2 型糖尿病(T2DM)患者的潜在益处而日益受到关注。GLP-1RA 类药物具有肾脏保护作用的大部分支持性证据来自心血管结果试验 (CVOT) 中报告的肾脏相关结果。研究表明,GLP-1RA 可减少白蛋白尿,降低心血管风险,并可能减轻肾小球滤过率(eGFR)的下降。GLP-1RA 的肾脏保护作用被认为归因于其抗炎、抗氧化和血管扩张特性。尽管这些研究结果很有希望,但使用 GLP-RAs 还没有明确证明能减缓 T2DM 患者慢性肾衰竭的进展。与安慰剂相比,塞马鲁肽在2型糖尿病和慢性肾脏病患者中的作用研究(FLOW试验)是首个评估GLP-1RA在减缓已确诊慢性肾脏病患者肾脏疾病进展至临床重要肾脏终点方面潜力的大型试验。2024 年 3 月 5 日,FLOW 公布了最高线结果,据报道,与安慰剂相比,1.0 毫克的semaglutide 可将试验的主要终点显著降低 24%。在此,我们总结了 GLP-1RA 类药物 CVOT 的肾脏疗效,并简要介绍了其他主要 GLP-1RAs 试验的肾脏疗效。我们还讨论了双重 GLP-1/ 葡萄糖依赖性胰岛素多肽 (GIP) 受体激动剂替塞帕肽作为肾脏保护剂的潜在作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Glucagon-like peptide-1 receptor agonists and kidney outcomes

Glucagon-like peptide-1 receptor agonists and kidney outcomes

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have gained increasing attention for their potential benefits in people with type 2 diabetes mellitus (T2DM) with chronic kidney disease (CKD). Most supportive evidence of a kidney-protective effect of the GLP-1RA class of medications has been derived from kidney-related outcomes reported from cardiovascular outcome trials (CVOTs). GLP-1RAs have been shown to reduce albuminuria, mitigate cardiovascular risk, and possibly attenuate estimated glomerular filtration rate (eGFR) decline. The kidney-protective effects of GLP-1RAs are thought to be attributed to their anti-inflammatory, antioxidant, and vasodilatory properties. Despite these promising findings, the use of GLP-RAs has yet to be definitively shown to slow progression to chronic kidney failure in people with T2DM. The Research Study to See How Semaglutide Works Compared to Placebo in People With Type 2 Diabetes and Chronic Kidney Disease (FLOW trial) is the first major trial assessing the potential of a GLP-1RA to slow progression of kidney disease in people with established CKD to clinically important kidney end points. On March 5, 2024, the top line result from FLOW was announced with semaglutide 1.0 mg being reported to reduce the primary end point of the trial by a significant 24% compared with placebo. Here, we summarize the kidney outcomes reported from CVOTs for the GLP-1RA class of medication and briefly describe kidney outcomes from other major GLP-1RAs trials. We also discuss a potential role of the dual GLP-1/glucose-dependent insulinotropic polypeptide (GIP) receptor agonist, tirzepatide, as a kidney-protective agent.

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来源期刊
Journal of Diabetes
Journal of Diabetes ENDOCRINOLOGY & METABOLISM-
CiteScore
6.50
自引率
2.20%
发文量
94
审稿时长
>12 weeks
期刊介绍: Journal of Diabetes (JDB) devotes itself to diabetes research, therapeutics, and education. It aims to involve researchers and practitioners in a dialogue between East and West via all aspects of epidemiology, etiology, pathogenesis, management, complications and prevention of diabetes, including the molecular, biochemical, and physiological aspects of diabetes. The Editorial team is international with a unique mix of Asian and Western participation. The Editors welcome submissions in form of original research articles, images, novel case reports and correspondence, and will solicit reviews, point-counterpoint, commentaries, editorials, news highlights, and educational content.
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