SGLT2i reduce risk of renal and HF outcomes for all eGFR categories. The greatest benefits in terms of kidney protection may be achieved by early initiation of SGLT2i in people with preserved eGFR. Greatest risk reduction for HF outcomes is observed in people with lower eGFR values (Diabetes, Obesity and Metabolism)
Diabetes News
Category: Nephropathy
Efficacy of Dapagliflozin by Baseline Diabetes Medications: A Prespecified Analysis From the DAPA-CKD Study
Dapagliflozin reduced kidney and cardiovascular events in patients with type 2 diabetes and CKD across baseline GLT class or classes in combination (Diabetes Care)
Effects of Dapagliflozin on Hospitalizations in Patients With Chronic Kidney Disease
Dapagliflozin reduced the risk for hospitalization for any cause in patients with CKD with and without type 2 diabetes (Annals of Internal Medicine)
Baseline eGFR, albuminuria and renal outcomes in patients with SGLT2 inhibitor treatment: an updated meta-analysis
Generally, the use of SGLT2i was consistently associated with decreased risk of renal events in all prespecified eGFR and albuminuria spectrums, even in patients with substantial renal impairment (Acta Diabetologica)
Beraprost Sodium Delays the Decline of Glomerular Filtration Rate in Patients with Diabetic Nephropathy: A Retrospective Study
Combination of conventional treatment and BPS therapy delays the decline of eGFR in patients with DN in the long term (Diabetes Therapy)
Validation of a Risk Prediction Model for Early Chronic Kidney Disease in Patients with Type 2 Diabetes: Data from the German/Austrian DPV Registry
The predictive model achieved moderate discrimination but good calibration in a German/Austrian T2D population suggesting that the model may be relevant for determining CKD risk (Diabetes, Obesity and Metabolism)
Optimal Frequency of Urinary Albumin Screening in Type 1 Diabetes
A personalized alternative to annual screening in type 1 diabetes can substantially reduce both the time with undetected kidney disease and the frequency of urine testing (Diabetes Care)
Empagliflozin in Patients with Chronic Kidney Disease
Among a wide range of patients with chronic kidney disease who were at risk for disease progression, empagliflozin therapy led to a lower risk of progression of kidney disease or death from cardiovascular causes than placebo (NEJM)
Impact of diabetes on the effects of sodium glucose co-transporter-2 inhibitors on kidney outcomes: collaborative meta-analysis of large placebo-controlled trials
In addition to the established cardiovascular benefits of SGLT2 inhibitors, the randomised data support their use for modifying risk of kidney disease progression and acute kidney injury, not only in patients with type 2 diabetes at high cardiovascular risk, but also in patients with chronic kidney disease or heart failure irrespective of diabetes status, primary kidney disease, or kidney function (The Lancet)
Suramin prevents the development of diabetic kidney disease by inhibiting NLRP3 inflammasome activation in KK-Ay mice
These results suggest that the NLRP3 inflammasome is activated in a diabetic kidney and that inhibition of the NLRP3 inflammasome with suramin protects against the progression of early stage DKD (Journal of Diabetes Investigation)
The Molecular Effects of SGLT2i Empagliflozin on the Autophagy Pathway in Diabetes Mellitus Type 2 and Its Complications
Hyperglycemia reduces LC3-II and ATG5 protein levels which contribute to deficiencies in the autophagy process, with development and progression of DN. SGLT2i significantly reduces progression of DN and onset of end-stage renal disease in T2DM patients, probably through its effect on autophagy (Journal of Diabetes Research)
Association of Lipopolysaccharide-Toll-Like Receptor 4 Signaling and Microalbuminuria in Patients with Type 2 Diabetes Mellitus
Intestinal integrity is compromised in subjects with T2DM, and the activation of LPS-TLR4 signaling might play an important role in the development of microalbuminuria in T2DM (Diabetes, Metabolic Syndrome and Obesity)
Glycaemic variability and progression of chronic kidney disease in people with diabetes and comorbid kidney disease: Retrospective cohort study
Glycaemic variability was strongly associated with the development of ESKD in people with diabetes and CKD (Diabetes Research and Clinical Practice)
Diabetes Management in Chronic Kidney Disease: A Consensus Report by the American Diabetes Association (ADA) and Kidney Disease: Improving Global Outcomes (KDIGO)
Consensus statements provide specific guidance on use of renin-angiotensin system inhibitors, metformin, sodium–glucose cotransporter 2 inhibitors, glucagon-like peptide 1 receptor agonists, and a nonsteroidal mineralocorticoid receptor antagonist. These areas of consensus provide clear direction for implementation of care to improve clinical outcomes of people with diabetes and CKD (Diabetes Care)
Canagliflozin reduces proteinuria by targeting hyperinsulinemia in diabetic patients with heart failure: a post-hoc analysis of the CANDLE trial
In patients with T2DM and CHF, regression of proteinuria with canagliflozin treatment was associated with the pre-treatment insulin level. These results may provide clinicians with novel mechanistic insights into the beneficial effects of canagliflozin on renal outcomes and may warrant discussion for selecting preferred patient profiles, including pre-treatment insulin levels (Diabetes, Obesity and Metabolism)
Finerenone in patients across the spectrum of chronic kidney disease and type 2 diabetes by GLP-1RA use
The cardiorenal benefits of finerenone on composite cardiovascular and kidney outcomes and UACR reduction in patients with CKD and T2D appear to be maintained, regardless of GLP-1RA use. Subsequent studies are needed to investigate any potential benefit of this combination (Diabetes, Obesity and Metabolism)
Sodium-Glucose Cotransporter 2 Inhibitors and Risk of Hyperkalemia in People With Type 2 Diabetes: A Meta-Analysis of Individual Participant Data From Randomized, Controlled Trials
SGLT2 inhibitors reduce the risk of serious hyperkalemia in people with type 2 diabetes at high cardiovascular risk or with chronic kidney disease without increasing the risk of hypokalemia (Circulation)
Large Effect Size in Composite Kidney Outcomes than in Majors Cardiovascular Events of SGLT2 inhibitors compared with GLP-1 RAs: A Pooled Analysis of Type 2 Diabetes Trials
In T2D patients, treatment effect sizes were greater for kidney than for macrovascular (MACE-3) outcomes, with important differences according to the drugs considered. CKO and MACE-3 are independent. Caution must be taken when interpreting CKO in the absence of MACE-3 data (Diabetes, Obesity and Metabolism)
Sodium–Glucose Cotransporter 2 Inhibitors in Cardiovascular and Renal Outcomes in Patients With Diabetes but Without Established Cardiovascular Disease: A Nationwide Population-Based Cohort Study
Our study provided clinical evidence that the cardiovascular and renoprotective benefits of SGLT2 inhibitors could be consistently extended to primary prevention strategies among patients with diabetes with low cardiovascular risk (Diabetes Care)
New insights into the role of empagliflozin on diabetic renal tubular lipid accumulation
EMPA inhibited the AGEs-RAGE pathway, thereby alleviating diabetic renal tubular cholesterol accumulation (Diabetology & Metabolic Syndrome)
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