Mejoría en el pronóstico renal con el uso de análogos del receptor GLP-1

Diabetes is currently the leading cause of chronic kidney disease and end-stage renal disease worldwide. Diabetic kidney disease is a complex and heterogeneous disease with numerous overlapping etiologic pathways leading to kidney damage.

We present the case of a 57-year-old man suffering from multiple diseases and cardiovascular risk factors with stage IIIb chronic renal failure with proteinuria close to 3 g/24 h. A complete study of the entity was carried out, ruling out systemic, hematological and/or urological aetiology, nor was the presence of secondary hypertension evident, with control of the same by means of quadruple therapy. Despite comprehensive hygienic-dietary and pharmacological management, no clinical improvement or control of the nephropathy was achieved. It was decided to reinforce treatment with subcutaneous semaglutide, with a very good metabolic response together with significant improvement in proteinuria and stabilization of renal function: both maintained during follow-up. The relevance of this case does not lie in the diagnostic difficulty or in being considered a atypical case, but rather in the existence of new therapeutic weapons that could alter the prognosis of the entity with a drastic reduction in cardiovascular morbidity and mortality and entry into renal replacement therapy.