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)
Diabetes News
Category: Nephropathy
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)
Effects of dapagliflozin on development and progression of kidney disease in patients with type 2 diabetes: an analysis from the DECLARE–TIMI 58 randomised trial
Dapagliflozin seemed to prevent and reduce progression of kidney disease compared with placebo inthis large and diverse population of patients with type 2 diabetes with and without established atheroscleroticcardiovascular disease, most of whom had preserved renal function (Lancet)
Renal effects of a sodium‐glucose cotransporter 2 inhibitor, tofogliflozin, in relation to sodium intake and glycaemic status
Dietary salt intake, in addition to glycaemic control, correlates with changed eGFRMDRD via tofogliflozin. Thus, an appropriate dietary approach to therapy should be considered before treatment of T2D patients with an SGLT2i (Diabetes, Obesity and Metabolism)
Albuminuria-lowering effect of dapagliflozin alone and in combination with saxagliptin and effect of dapagliflozin and saxagliptin on glycaemic control in patients with type 2 diabetes and chronic kidney disease (DELIGHT)
Dapagliflozin with or without saxagliptin, given in addition to angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker treatment, is a potentially attractive option to slow the progression of kidney disease in patients with type 2 diabetes and moderate-to-severe chronic kidney disease (The Lancet Diabetes & Endocrinology)
Atrasentan and renal events in patients with type 2 diabetes and chronic kidney disease (SONAR): a double-blind, randomised, placebo-controlled trial
Atrasentan reduced the risk of renal events in patients with diabetes and chronic kidney disease who were selected to optimise efficacy and safety. These data support a potential role for selective endothelin receptor antagonists in protecting renal function in patients with type 2 diabetes at high risk of developing end-stage kidney disease. (The Lancet)
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)
Type 2 diabetes and the kidney: insights from cardiovascular outcome trials
There is room for optimism that use of SGLT‐2 inhibitors may change the paradigm of the ineluctable progression of DKD (Diabetes, Obesity and Metabolism)
A need-based approach to self-management education for adults with co-morbid diabetes and chronic kidney disease
Patients with co-morbid diabetes and kidney disease have education gaps on the management of, and complications of diabetes and kidney disease. Interventions aimed at improving patient education need to be delivered through education resources co-developed by patients and health staff. A targeted education resource in the form of a DVD, addressing these needs, may potentially close these gaps (BMC Nephrology)
Variations in glucose /C-peptide ratio in patients with type 2 diabetes associated with renal function
Diminished renal function and advanced age are associated with the lowest glucose/C-peptide ratios, independent of achieved glycemic control. With similar use of secretogogues, glucose/C-peptide ratio were lower when eGFR was ≤ 49ml/min compared to >50-80 ml/min. Use of secretogogues was associated with decreased glucose/C-peptide levels (Diabetes Research and Clinical Practice)
The relationships between markers of tubular injury and intrarenal haemodynamic function in adults with and without type 1 diabetes: Results from the Canadian Study of Longevity in Type 1 Diabetes
Elevated NGAL relates to intrarenal haemodynamic dysfunction in T1D, whereas elevated NGAL and B2M relate to intrarenal haemodynamic dysfunction in adults without T1D. These data may define a diabetes‐specific interplay between tubular injury and intrarenal haemodynamic dysfunction (Diabetes, Obesity and Metabolism)
Albuminuria Regression and All-Cause Mortality among Insulin-Treated Patients with Type 2 Diabetes: Analysis of a Large UK Primary Care Cohort
In patients with insulin-treated T2D and nephropathy in routine practice, a regression in albuminuria (e.g., via better BP or glycemic control) is associated with a significant reduction in all-cause mortality. Thus, albuminuria is not only simply a risk marker of renal and CV disease but also an independent target for therapy. Albuminuria reduction should be viewed as a goal for renal and CV protection (Nephrology)
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