In these analyses from the VERTIS CV trial, markers of volume status and haemoconcentration and/or haematopoiesis were the strongest mediators of the effect of ertugliflozin on reducing risk of HHF and composite kidney outcomes in the early and average change periods (Diabetes, Obesity and Metabolism)
Diabetes News
Category: Nephropathy
Incidence rate patterns, cumulative incidence, and time trends for moderate and severe albuminuria in individuals diagnosed with type 1 diabetes aged 0–14 years: a population-based retrospective cohort study
Our analyses show that the cumulative incidence of severe albuminuria has decreased between 1970–79 and 1980–99; however, whether this decrease solely denotes a delay in albuminuria, or also a true prevention of albuminuria, needs to be investigated further. Nevertheless, diabetic kidney disease remains a significant complication of type 1 diabetes. Due to the robust association of diabetic kidney disease with premature mortality, novel therapies to improve prognosis are needed (The Lancet Diabetes & Endocrinology)
Effect of dapagliflozin on kidney and cardiovascular outcomes by baseline KDIGO risk categories: a post hoc analysis of the DAPA-CKD trial
The consistent benefits of dapagliflozin on kidney and cardiovascular outcomes across KDIGO risk categories indicate that dapagliflozin is efficacious and safe across a wide spectrum of kidney disease severity (Diabetologia)
Efficacy and safety of cotadutide, a dual GLP-1 and glucagon receptor agonist, in a randomized phase 2a study of patients with type 2 diabetes and chronic kidney disease
We established the efficacy of cotadutide in this patient population, with significantly improved postprandial glucose control and reduced bodyweight versus placebo. Reductions in UACR suggest potential benefits of cotadutide on kidney function, supporting further evaluation in larger, longer-term clinical trials (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 and/or with CKD, without increasing the risk of hypokalemia
Efficacy of liraglutide in patients with diabetic nephropathy: a meta-analysis of randomized controlled trials
Liraglutide reduced the levels of Blood Glucose, BMI, renal outcome indicators, and serum inflammatory factors of patients with T2DN, suggesting the beneficial effects of liraglutide on renal function (BMC Endocrine Disorders)
Effects of Pentoxifylline on Serum Markers of Diabetic Nephropathy in Type 2 Diabetes
Add-on pentoxifylline to losartan may have more effective anti-inflammatory and anti-albuminuric roles and therefore may be more applicable in the management of diabetic nephropathy compared with high-dose losartan alone (Diabetes Therapy)
Coming Full Circle: Prioritizing Early Glycemic Control to Reduce Microvascular and Macrovascular Complications in People With Type 2 Diabetes
Analysis from the Dapagliflozin Effect on Cardiovascular Events trial (DECLARE-TIMI 58) on the association of baseline HbA1c with cardiovascular and kidney outcomes (Diabetes Care)
Renoprotective effect of additional sodium-glucose cotransporter 2 inhibitor therapy in type 2 diabetes patients with rapid decline and preserved renal function
Early intervention with SGLT2i may have renoprotective effects in T2D patients with rapid decline and preserved renal function (Journal of Diabetes Investigation)
Modifying chronic kidney disease progression with the mineralocorticoid receptor antagonist finerenone in patients with type 2 diabetes
These studies have established finerenone, a novel nonsteroidal mineralocorticoid receptor antagonist, as an effective treatment for kidney and CV protection and welcomed addition to the pillars of treatment to slow CKD progression in patients with T2D (Diabetes, Obesity and Metabolism)
Modeling Chronic Kidney Disease in Type 2 Diabetes Mellitus: A Systematic Literature Review of Models, Data Sources, and Derivation Cohorts
Modeling CKD in T2DM is an active research area, with a trend towards IPS models developed from non-Western data and single data sources, primarily recent outcomes trials of novel renoprotective treatments (Diabetes Therapy)
Effect of glucagon-like peptide-1 receptor agonists on renal function: a meta-analysis of randomized controlled trials
Results of our meta-analysis revealed that GLP-1 RA treatment decreases urinary albumin excretion and albumin to creatinine ratio but it did not cause significant changes in creatinine levels and glomerular filtration rate (British Journal of Clinical Pharmacology)
Glomerular resistances predict long-term GFR decline in type 2 diabetic patients without overt nephropathy: a longitudinal subgroup analysis of the DEMAND trial
These findings could be explained by glomerular hypoperfusion and chronic ischemic injury related to pre-glomerular arteriolar narrowing (Acta Diabetologica)
Glucagon-Like Peptide-1 Receptor Agonist Use in People Living with Type 2 Diabetes Mellitus and Chronic Kidney Disease: A Narrative Review of the Key Evidence with Practical Considerations
Here, we review evidence on GLP-1 RA use in people living with T2DM and CKD and summarize renal outcomes from clinical studies. We provide practical considerations for GLP-1 RA use to provide an added benefit to guide treatment in this high-risk patient population (Diabetes Therapy)
Cardiovascular and Renal Outcomes with Canagliflozin in Patients with Peripheral Artery Disease: Data from the CANVAS program and CREDENCE trials
Patients with T2D and PAD derived similar relative cardiorenal benefits from canagliflozin treatment but higher absolute benefits compared to those without PAD, with no increase in MALE (Diabetes, Obesity and Metabolism)
Effects of empagliflozin on markers of liver steatosis and fibrosis and their relationship to cardiorenal outcomes
Empagliflozin may reduce steatosis but not fibrosis risk in individuals with type 2 diabetes and cardiovascular disease. The improvements in cardiorenal outcomes and mortality associated with empagliflozin therapy appear to be independent of steatosis and fibrosis risk (Diabetes, Obesity and Metabolism)
Glomerular filtration rate abnormalities in children with type 1 diabetes
A notable proportion of children with T1D demonstrate eGFR abnormalities early in their T1D course. This finding along with evidence of eGFR declining over time is concerning for long-term risk of CKD and warrants systematic serum creatinine monitoring at diagnosis and regular intervals thereafter in children with T1D (Canadian Journal of Diabetes)
Predictors of cardio-kidney complications and treatment failure in patients with chronic kidney disease and type 2 diabetes treated with SGLT2 inhibitors
Our study demonstrated high rates of residual cardio-kidney outcomes and treatment failure in patients with DKD treated with SGLT2is. Patients with high baseline CV risk and the presence of certain conditions, such as atrial fibrillation, PVD, and heart failure, were at higher risk for cardio-kidney events (BMC Medicine)
Prediabetes and risk of mortality, diabetes-related complications and comorbidities: umbrella review of meta-analyses of prospective studies
Prediabetes was positively associated with risk of all-cause mortality and the incidence of cardiovascular outcomes, CHD, stroke, chronic kidney disease, cancer and dementia (Diabetologia)
Activation of complement C1q and C3 in glomeruli might accelerate the progression of diabetic nephropathy: Evidence from transcriptomic data and renal histopathology
Complement activation is involved in the development of DN, and activation of the classical complement pathway in glomeruli might accelerate disease progression (Journal of Diabetes Investigation)
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