In DKD subjects, Linagliptin promotes an increase in CXCR4 expression on CD34 + progenitor cells with a concomitant improvement in vascular and renal parameters at 12 weeks (Cardiovascular Diabetology)
Diabetes News
Category: Nephropathy
Canagliflozin for the Treatment of Diabetic Kidney Disease and Implications for Clinical Practice: A Narrative Review
Overall, the CREDENCE trial demonstrated that canagliflozin improves renal outcomes and slows early disease progression in people with DKD (Diabetes Therapy)
Association between reduced kidney function and incident hypoglycemia in people with diabetes; the Stockholm CREAtinine Measurements (SCREAM) project
In this large, observational study, low eGFR strongly associated with the occurrence, severity and fatality of hypoglycemia in persons with diabetes (Diabetes, Obesity and Metabolism)
Effects of ertugliflozin on renal function over 104 weeks of treatment: a post hoc analysis of two randomised controlled trials
Ertugliflozin reduced eGFR at week 6, consistent with the known pharmacodynamic effects of SGLT2 inhibitors on renal function. Over 104 weeks, eGFR values returned to baseline and were higher with ertugliflozin compared with non-ertugliflozin treatment, even though changes in HbA1c did not differ between the groups. Ertugliflozin reduced UACR in patients with baseline albuminuria (Diabetologia)
A metabolomics based molecular pathway analysis for how the SGLT2‐inhibitor dapagliflozin may slow kidney function decline in patients with diabetes
The observed molecular pathways targeted by dapagliflozin and associated with DKD suggest that modifying molecular processes related to energy metabolism, mitochondrial function, and endothelial function may contribute to its renal protective effect (Diabetes, Obesity and Metabolism)
The incidence, risk factors, and long-term outcomes of acute kidney injury in hospitalized diabetic ketoacidosis patients
Multiple risk factors contribute to the development of AKI in DKA patients. AKI and advanced AKI stage are associated with rapid progressive CKD and long-term mortality in patients with DKA (BMC Nephrology)
SGLT‐2 Inhibitor Renal Outcome Modification in Type‐2 Diabetes: Evidence from Studies in Patients with High or Low Renal Risk
While confirmatory of the exploratory data from CVOTs, CREDENCE provides the first robust data on the effects of canagliflozin on patient relevant renal endpoints. Extrapolation to a conclusion of a SGLT2 inhibitor class effect cannot be made until additional renal trials with other SGLT2 inhibitors are reported (Diabetes, Obesity and Metabolism)
Are the cardiovascular and kidney benefits of empagliflozin influenced by baseline glucose‐lowering therapy?
The addition of empagliflozin to anti‐hyperglycemic regimens of patients with type 2 diabetes and CV disease consistently reduced their risks of adverse CV outcomes and mortality irrespective of baseline use of metformin, sulfonylurea, or insulin. For CKD progression, there may be a larger benefit from empagliflozin in those patients who are not using metformin (Diabetes, Obesity and Metabolism)
Impact of chronic kidney disease definition on assessment of its incidence and risk factors in patients with newly diagnosed type 1 and type 2 diabetes in the UK
A cohort study using primary care data from the United Kingdom (Primary Care Diabetes)
ANGPTL4: A Predictive Marker for Diabetic Nephropathy
Altogether, this suggests a potential role for ANGPTL4 in DN perhaps through its role in inhibiting LPL activity and promotes ANGPTL4 as a biochemical marker for the detection of a diabetic kidney disease in patients with T2D (Journal of Diabetes Research)
Efficacy and safety of mineralocorticoid receptor antagonists with ACEI/ARB treatment for diabetic nephropathy: A meta‐analysis
MRAs can significantly reduce proteinuria and increase blood creatinine in DN patients under blockade of the renin‐angiotensin system. The combination treatment of finerenone and ACEI/ARB runs a lower risk of hyperkalaemia than eplerenone or spironolactone (International Journal of Clinical Practice)
Canagliflozin Improves Erythropoiesis in Diabetes Patients with Anemia of Chronic Kidney Disease
Canagliflozin treatment led to an improvement in erythropoiesis in patients with impaired kidney function. The effect on erythropoiesis appeared to be due to an EPO production-mediated mechanism and might be independent of glycemic control; however, further studies are needed to clarify this since the present study had a small sample size and no comparator group (Diabetes Technology and Therapeutics)
Association of diabetes-related kidney disease with cardiovascular and non-cardiovascular outcomes: a retrospective cohort study
Diabetes-related kidney disease appears to be formally diagnosed at a more advanced stage than might be expected, given clinical practice guidelines. Risks of cardiovascular and non-cardiovascular outcomes are high (BMC Endocrine Disorders)
Impact of angiotensin‐converting enzyme inhibitors or angiotensin receptor blockers on renal and mortality outcomes in people with Type 2 diabetes and proteinuria
Angiotensin‐converting enzyme inhibitors and angiotensin receptor blockers may reduce the risk of end‐stage renal disease and slow the progression of nephropathy, but they do not appear to decrease all‐cause or cardiovascular mortality in people with Type 2 diabetes and proteinuria (Diabetic Medicine)
Risk factors in metabolic syndrome predict the progression of diabetic nephropathy in patients with type 2 diabetes
The presence of metabolic syndrome independently predicts DKD progression in patients with type 2 diabetes (Diabetes Research and Clinical Practice)
The relationship between eGFR slope and subsequent risk of vascular outcomes and all-cause mortality in type 2 diabetes: the ADVANCE-ON study
Our study supports the utility of eGFR slope in type 2 diabetes as a surrogate endpoint for renal outcomes, as well as a prognostic factor for identifying individuals at high risk of cardiovascular disease and all-cause mortality (Diabetologia)
Diagnostic Performance of Retinopathy in the Detection of Diabetic Nephropathy in Type 2 Diabetes: A Systematic Review and Meta-Analysis of 45 Studies
DR is helpful in diagnosing DN in persons with type 2 diabetes and kidney disease, but the severity of DR may not parallel the presence of DN (Ophthalmic Research)
Progressive Decline in Estimated Glomerular Filtration Rate in Patients With Diabetes After Moderate Loss in Kidney Function—Even Without Albuminuria
Our results support a diabetes-dependent decline in kidney function without albuminuria following CKD3, with a subgroup showing a progressive decline. Furthermore, this group seems to be undertreated in terms of cardioprotective and renal-protective treatment and suggests that increased attention should be drawn to normoalbuminuric diabetic kidney disease (Diabetes Care)
Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy
In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years (NEJM)
Early Glomerular Hyperfiltration and Long-Term Kidney Outcomes in Type 1 Diabetes
Early hyperfiltration in patients with type 1 diabetes was not associated with a higher long-term risk of decreased GFR. Although glomerular hypertension may be a mechanism of kidney injury in DKD, higher total GFR does not appear to be a risk factor for advanced DKD (Clinical Journal of the American Society of Nephrology)
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