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)
Diabetes News
Category: Nephropathy
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)
Sodium–Glucose Cotransporter 2 Inhibition and Diabetic Kidney Disease
SGLT2 inhibitors show great promise for prevention and treatment of DKD. Trials with empagliflozin have demonstrated, for the first time, a reduction in all-cause and cardiovascular mortality in patients with T2D and CKD (Diabetes)
Clinical Trials on Diabetic Nephropathy: A Cross-Sectional Analysis
Despite the financial and human resources involved and the relevance for therapeutic guidelines and clinical decisions, about one-third of phase III clinical trials on diabetic nephropathy remain unpublished. Interventions used in published trials showed a low efficacy on renal outcome (Diabetes Therapy)
The ratio of AGE to sRAGE independently associated with albuminuria in hypertensive patients
This study suggests that the ratio of AGE to sRAGE may be a surrogate biomarker for microvascular injury (BMC Endocrine Disorders)
Efficacy of a novel inhibitor of vascular adhesion protein-1 in reducing albuminuria in patients with diabetic kidney disease (ALBUM): a randomised, placebo-controlled, phase 2 trial
ASP8232 is effective in reducing albuminuria in patients with diabetic kidney disease and is safe and well tolerated. These findings warrant further research to ascertain the effect of ASP8232 on delaying progression of diabetic kidney disease (The Lancet Diabetes & Endocrinology)
Correlation Between Different Stages of Diabetic Nephropathy and Neuropathy in Patients with T2DM
The results suggest that diabetic nephropathy is closely associated with the development of DPN in T2DM patients and that UAER and disease duration can be used as warning indicators of DPN progression (Diabetes Therapy)
Non-albuminuric renal impairment is a strong predictor of mortality in individuals with type 2 diabetes
The Renal Insufficiency And Cardiovascular Events (RIACE) Italian multicentre study (Diabetologia)
Optimization of kidney dysfunction prediction in diabetic kidney disease using targeted metabolomics
Targeted metabolomics using blotted samples in filter paper is a simple, low-cost approach to identify outcomes associated with DKD; the inclusion of metabolomics improves predictive capacity of clinical models to identify kidney dysfunction and DKD-related outcomes (Acta Diabetologica)
Urinary tubular biomarkers as predictors of kidney function decline, cardiovascular events and mortality in microalbuminuric type 2 diabetic patients
In patients with T2D and persistent microalbuminuria, u-KIM-1, but not u-NGAL, was an independent risk factor for decline in eGFR, CVE and all-cause mortality, and contributed significant discrimination for all-cause mortality, beyond traditional risk factors (Acta Diabetologica)
Association of Metformin Use With Risk of Lactic Acidosis Across the Range of Kidney Function
In 2 real-world clinical settings, metformin use was associated with acidosis only at eGFR less than 30 mL/min/1.73 m2. Our results support cautious use of metformin in patients with type 2 diabetes and eGFR of at least 30 mL/min/1.73 m2 (JAMA)
Multiple risk factor control, mortality and cardiovascular events in type 2 diabetes and chronic kidney disease: a population-based cohort study
Multiple risk factor control (MRFC) may lower the increased risks for mortality and cardiovascular events in people with diabetes and CKD (BMJ Open)
New Diabetes Therapies and Diabetic Kidney Disease Progression: the Role of SGLT-2 Inhibitors
The glucose-independent hemodynamic mechanisms of SGLT-2 inhibitors provide the possibility to extend the use of SGLT-2 inhibitors to non-diabetic kidney disease (Current Diabetes Reports)
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