Here, we review the role of the adaptive immune system, and associated cytokines, in the development of DKD. Furthermore, the potential therapeutic benefits of targeting the adaptive immune system as a means of preventing the progression of DKD will be discussed (Journal of Diabetes Investigation)
Diabetes News
Category: Nephropathy
Chronic kidney disease: assessment and management
This guideline covers care and treatment for people with, or at risk of, chronic kidney disease (CKD). It aims to prevent or delay the progression, and reduce the risk of complications and cardiovascular disease. It also covers managing anaemia and hyperphosphataemia associated with CKD (NICE)
Utilization of glucagon-like peptide-1 receptor agonists and changes in clinical characteristics in type 2 diabetes mellitus patients by chronic kidney disease stage in Japan
The utilization of GLP-1 RA has been increasing over the past decade, and GLP-1 RAs have been used in patients with limited treatment options, such as the elderly or those with CKD. In T2DM patients with CKD, the persistence proportion of GLP-1 RAs was not low, and the renal dysfunction may be moderated by GLP-1 RA initiation (Diabetes, Obesity and Metabolism)
Comparative cardiovascular and renal effectiveness of sodium-glucose co-transporter 2 inhibitors and glucagon-like peptide 1 receptor-agonists: Scandinavian cohort study
Use of SGLT2 inhibitors vs GLP-1-receptor-agonists was associated with a similar risk of heart failure and lower risk of serious renal events while use of GLP-1-receptor-agonists vs SGLT2 inhibitors was associated with a slightly lower risk of MACE. In as-treated analyses, the associations with MACE and serious renal events increased in magnitude and the HR for heart failure tended towards a protective association for SGLT2 inhibitors (Diabetes, Obesity and Metabolism)
Jardiance® shows consistent cardio-renal benefits in adults with heart failure with left ventricular ejection fraction over 40% regardless of chronic kidney disease status
In a new sub-analysis of the landmark EMPEROR-Preserved® phase III trial, Jardiance reduced the combined relative risk of cardiovascular death and hospitalization for heart failure and slowed kidney function decline (Boehringer Ingelheim and Eli Lilly)
Renal Complications and Duration of Diabetes: An International Comparison in Persons with Type 1 Diabetes
This analysis used three nationwide registries of persons with T1D. Despite recent use of more effective diabetes therapies, a substantial proportion of persons with T1D have renal complications at < 20 years after diagnosis. Efficient glucose-lowering and renal-protective strategies are needed in persons with T1D (Diabetes Therapy)
Kidney Outcomes Associated With SGLT2 Inhibitors Versus Other Glucose-Lowering Drugs in Real-world Clinical Practice: The Japan Chronic Kidney Disease Database
The benefits of SGLT2 inhibitors on kidney function as observed in clinical trials translate to patients treated in clinical practice with no evidence that the effects are modified by the underlying rate of kidney function decline or the presence of proteinuria (Diabetes Care)
Dissociation of Glycated Albumin and HbA1c Is Associated With a Decline of Glomerular Filtration Rate as Evaluated by Inulin Clearance
In conclusion, GA and HbA1c are dissociated by GFR reduction in patients with glycemic disorder, and eGFR and HbA1c may not provide an accurate measure of the risk of DKD. Thus, care is needed in evaluating glycemic control using HbA1c in patients with kidney dysfunction (Diabetes Care)
Effect of Dipeptidyl Peptidase-4 (DPP-4) Inhibition on Biomarkers of Kidney Injury and Vascular Calcification in Diabetic Kidney Disease: A Randomized Controlled Trial
Our study showed that gemigliptin significantly improved the expression of renal tubular injury biomarkers and vascular calcification levels among patients with DKD; however, gemigliptin did not affect renal function or coronary calcification compared with those observed in the control (Journal of Diabetes Research)
Performance of prediction models for nephropathy in people with type 2 diabetes: systematic review and external validation study
This study identified multiple prediction models to predict albuminuria, diabetic kidney disease, chronic kidney disease, and end stage renal disease. In the external validation, discrimination and calibration for albuminuria, diabetic kidney disease, and chronic kidney disease varied considerably across prediction horizons and models (BMJ)
Increased risk for microvascular complications among women with gestational diabetes in the third trimester The Microalbuminuria and Retinopathy in Gestational Diabetes (MARIGOLD) Study
Women with gestational diabetes have an increased risk of microalbuminuria in the third trimester, despite having been exposed to only a brief period of overt hyperglycaemia (Diabetes Research and Clinical Practice)
Renal hemodynamic effects differ between antidiabetic combination strategies: randomized controlled clinical trial comparing empagliflozin/linagliptin with metformin/insulin glargine
In patients with type 2 diabetes and preserved renal function treatment with M+I resulted in reduction of renal perfusion and increase in vascular resistance, in contrast to treatment with E+I that preserved renal perfusion and reduced vascular resistance (Cardiovascular Diabetology)
Effects of canagliflozin on serum potassium in people with diabetes and chronic kidney disease: the CREDENCE trial
Among patients treated with renin–angiotensin–aldosterone system inhibitors, SGLT2 inhibition with canagliflozin may reduce the risk of hyperkalaemia in people with T2DM and CKD without increasing the risk of hypokalaemia (European Heart Journal)
Cardiovascular, mortality, and kidney outcomes with GLP-1 receptor agonists in patients with type 2 diabetes: a systematic review and meta-analysis of randomised trials
GLP-1 receptor agonists, regardless of structural homology, reduced the risk of individual MACE components, all-cause mortality, hospital admission for heart failure, and worsening kidney function in patients with type 2 diabetes (The Lancet Diabetes & Endocrinology)
Glycemic Variability and KIM-1–Induced Inflammation in the Diabetic Kidney
Recognition of DKD as an inflammatory disease linked by metabolic perturbations and immune responses is a central tenet that requires broader and deeper exploration (Diabetes)
Effect of Mineralocorticoid Receptor Antagonism and ACE Inhibition on Angiotensin Profiles in Diabetic Kidney Disease: An Exploratory Study
Combined eplerenone and ACEi therapy increases Ang-(1–7) levels in patients with CKD indicating a unique nephroprotective RAAS pattern with considerable therapeutic implications (Diabetes Therapy)
SGLT2 inhibition reduces cellular senescence in the diabetic kidney by promoting ketone body-induced NRF2 activation
Dapagliflozin prevented the progression of diabetic kidney disease by inhibiting cellular senescence and oxidative stress via ketone-induced NRF2 activation (Diabetes, Obesity and Metabolism)
Renoprotective effects of sodium glucose cotransporter 2 inhibitors in type 2 diabetes patients with decompensated heart failure
Lower plasma BNP level and the use of RASI at baseline were the key factors contributing to the renoprotective effects of SGLT2i among patients with decompensated HF and T2DM (BMC Cardiovascular Disorders)
Relationship Between the TyG Index and Diabetic Kidney Disease in Patients with Type-2 Diabetes Mellitus
The TyG Index is a potential predictor for DKD in T2DM patients (Metabolic Syndrome and Obesity)
Effect of Finerenone on Chronic Kidney Disease Outcomes in Type 2 Diabetes
In patients with CKD and type 2 diabetes, treatment with finerenone resulted in lower risks of CKD progression and cardiovascular events than placebo (NEJM)
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