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)
Diabetes News
Category: Nephropathy
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)
The Association of Postprandial Triglyceride Variability with Renal Dysfunction and Microalbuminuria in Patients with Type 2 Diabetic Mellitus
Postprandial TG variability is a novel risk factor for eGFR decline and the incidence of microalbuminuria in patients with type 2 DM (Journal of Diabetes Research)
Combined SGLT-2 and ACE inhibition upregulates the renin-angiotensin system in chronic kidney disease with type 2 diabetes: Results of a randomized, double-blind, placebo-controlled exploratory trial
A distinct RAS modulation by SGLT-2i occurs in diabetic kidney disease reflected by enhancement of the beneficial Angiotensin-(1–7) providing a molecular background for this renoprotective therapeutic approach (Diabetes, Obesity and Metabolism)
Network meta-analysis on the effects of SGLT2 inhibitors versus finerenone on cardiorenal outcomes in patients with type 2 diabetes and chronic kidney disease
Given the above limitations of this study, its findings may suggest that among patients with T2D and CKD SGLT2 inhibitors are more effective than finerenone in reducing renal and cardiovascular endpoints, especially renal and cardiac failure events(Frontiers in Pharmacology)
Kerendia
The Committee for Medicinal Products for Human Use (CHMP) adopted a positive opinion, recommending the granting of a marketing authorisation for the medicinal product Kerendia, intended for the treatment of chronic kidney disease associated with type 2 diabetes in adults (EMA)
SGLT-2 inhibitors and cardiorenal outcomes in patients with or without type 2 diabetes: a meta-analysis of 11 CVOTs
Therapy with SGLT-2 inhibitors in patients with cardiometabolic and renal diseases results in a sustained to moderate reduction of the composite CV death or hospitalization for HF, robust reduction of HF and renal outcomes, moderate reduction of CV mortality, total mortality and MACE (Cardiovascular Diabetology)
Effect of the Glucagon-like Peptide-1 Receptor Agonists Semaglutide and Liraglutide on Kidney Outcomes in Patients With Type 2 Diabetes: a Pooled Analysis of SUSTAIN 6 and LEADER Trials
In patients with T2D, semaglutide/liraglutide offered kidney-protective effects, which appeared more pronounced in those with pre-existing chronic kidney disease (Circulation)
The role of the adaptive immune system in diabetic kidney disease (DKD)
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)
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)
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