Nephroprotective potential of glucagon-like peptide-1 receptor agonists

Шамхалова, Минара Шамхаловна; Шамхаловна, Шамхалова Минара; Sklyanik, Igor A.; Александрович, Скляник Игорь; Shestakova, Marina Vladimirovna; Владимировна, Шестакова Марина

doi:10.14341/dm12379

Cited by 4 publications

(1 citation statement)

References 14 publications

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“…Конечная комбинированная почечная точка значимо реже фиксировалась в группе пациентов, получавших дулаглутид [848 (17,1%)], чем в группе пациентов, получавших плацебо [970 (19,6%)] (ОР 0,86; 95% ДИ 0,77-0,93; р=0,0004). Анализ вторичных почечных исходов у пациентов среднего и пожилого возраста со средней расчетной СКФ 76,9 мл/мин/1,73 м 2 и наличием патологической альбуминурии в 35% случаев продемонстрировал значимое снижение риска развития комбинированной конечной почечной точки в сравнении с плацебо [39].…”

Section: лечение днunclassified

Diabetic nephropathy: what should cardiologist remember

Trubitsyna¹,

Зайцева²,

Severina³

2021

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Prevalence of diabetes mellitus (DM) progressively increases around the world. Diabetic nephropathy (DN) is significant reason of end-stage renal disease and it is associated with high risk of cardiovascular disease and mortality. Necessity of expensive renal replacement therapy for patients with prominent vascular diabetic complications and end-stage renal disease has significant socio-economic impact. DM, as a one of leading causes of kidney diseases, competes for stricted resources of public health. Renal replacement therapy in patients with DM does not solve the whole problem, because survival of such patients is low, comparing with another kidney diseases, first of all because of cardiovascular diseases. Good control of glycaemia, blood pressure and cholesterol level and prescription of renin-angiotensin-aldosterone system inhibitors and statins decrease cardiovascular risk and slow down DN progression, as it was shown in many clinical trials. So patients with DM and DN should receive complex therapy for risk reduction of kidney disease and cardiovascular disorders progression. Keywords: diabetes mellitus type 2, diabetic nephropathy, nephroprotection, cardioprotection, SGLT-2 inhibitors, GLP-1 agonists, renin-angiotensin-aldosterone system For citation: Trubitsyna NP, Zaitseva NV, Severinа AS. Diabetic nephropathy: what should cardiologist remember. Consilium Medicum. 2021; 23 (1): 20–24. DOI: 10.26442/20751753.2021.1.200712

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Section: лечение днunclassified

Diabetic nephropathy: what should cardiologist remember

Trubitsyna¹,

Зайцева²,

Severina³

2021

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Chronic kidney disease in patients with type 2 diabetes: new targets of medicine action

et al. 2022

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Diabetes mellitus type 2 (DM2) is socially important disease, becoming non-infectious epidemic due to increasing prevalence. Chronic kidney disease (CKD) is one of the most common diabetic complications. Kidney injury signs and/or estimated glomerular filtration rate (eGFR) decrease are seen in 40-50% of patients with DM2. Three groups of factors are considered to be the basis of CKD development and progression in DM2: metabolic, hemodynamic, inflammation and fibrosis. Existing drugs that are used in patients with CKD and DM2 first of all target hemodynamic and metabolic disturbances, but their action against inflammation and fibrosis is indirect. Hyperactivation of mineralocorticoid receptors (MR) is considered as one of the main trigger factors of end-organ damage in patients with DM2 due to inflammation and fibrosis. Development of selective nonsteroidal MR antagonists (MRA) as a new class of medications is directed to demonstrate positive effects from blocking this pathophysiological pathway of CKD development and overcome the steroidal MRAs’ shortcomings. Hence pathophysiological hyperactivation of MR with subsequent inflammation and fibrosis in patients with CKD in DM2 is considered a promising therapeutic target for the new drugs with cardionephroprotective effect.

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Advantages of glucagon-like peptide agonists in the light of prevention of cardiovascular and renal complications

Demidova,

Titova,

Skuridina

2023

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Glucagon-like peptide-1 receptor agonists (arGPP-1) have proven their advantages in persistent reduction of glycemia and HbA1c and achieving targeted control in patients with type 2 diabetes mellitus (DM2) as monotherapy or in combination with other medications. These drugs are also highly effective in reducing body weight for both patients with and without DM2.The research results indicate the potential of arGPP-1 in reducing cardiovascular events, especially in patients with pre-existing atherosclerotic diseases. Although with a low risk of cardiovascular disease, such effects may be less obvious.The presence of side effects, especially from the gastrointestinal tract (GI tract), the high cost and low availability of drugs may be a limitation for their use. In addition, the advantages in relation to the possible prevention of late complications of DM2 within the group are heterogeneous, if the patient has risk factors, drugs with proven effects on cardiovascular and renal outcomes may have advantages. Thus, in some cases, patients may need to change the drug within this class. At the same time, it is important to make a smooth transition between drugs to optimize the treatment of diabetes mellitus and minimize side effects.

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Nephroprotective potential of glucagon-like peptide-1 receptor agonists

Cited by 4 publications

References 14 publications

Diabetic nephropathy: what should cardiologist remember

Diabetic nephropathy: what should cardiologist remember

Chronic kidney disease in patients with type 2 diabetes: new targets of medicine action

Advantages of glucagon-like peptide agonists in the light of prevention of cardiovascular and renal complications

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