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)
Diabetes News
Category: Nephropathy
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guidelines and clinical decisions, about one-third of phase III clinical trials on diabetic nephropathy remain unpublished.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)
Diabetic Kidney Disease: Is There a Role for Glycemic Variability?
Glycemic variability may be a factor in the development of DKD, but definitive evidence is lacking. Currently, all available glycemic biomarkers, including A1C, have limitations and in the setting of DKD and should be used cautiously. Emerging data suggest that personal and professional CGM will play an important role in managing diabetes in patients with DKD, where risk of hypoglycemia is high (Current Diabetes Reports)
Nerve function varies with hemoglobin A1c in controls and type 2 diabetes
These findings underscore the importance of early treatment at the prediabetes and early diabetes stages to prevent nerve fiber decline that is likely irreversible (Diabetes and Its Complications)
Glucose targets for preventing diabetic kidney disease and its progression
Overall, this evidence summary does not support the use of tighter glucose control to offer people with diabetes a lower risk of premature mortality or protection against kidney failure (Cochrane)
ACE Inhibitors and Statins in Adolescents with Type 1 Diabetes
The use of an ACE inhibitor and a statin did not change the albumin-to-creatinine ratio over time (NEJM)
Alprostadil protects type 2 diabetes mellitus patients treated with metformin from contrast-induced nephropathy
Alprostadil hydration was superior to drinking water monohydration regarding preventing CIN in T2DM patients treated with metformin after contrast-enhanced CT (International Urology and Nephrology)
Acute Kidney Injury in Patients on SGLT2 Inhibitors: A Propensity-Matched Analysis
Our findings do not suggest an increased risk of AKI associated with SGLT2 inhibitor use in patients with T2D in two large health systems (Diabetes Care)
Association of angiotensin-II levels with albuminuria in subjects with normal glucose metabolism, prediabetes, and type 2 diabetes mellitus
Angiotensin-II may play an important role in the development of albuminuria, particularly in subjects with impaired glucose metabolism (Journal of Diabetes and Its Complications)
Classification and Differential Diagnosis of Diabetic Nephropathy
Regardless of its limitations, the Tervaert classification represents a very meaningful step towards the establishment of a DN classification scheme with clinical utility. When the pathologist observes the pathological changes of DN, they still need to make a differential diagnosis with another nodular glomerulopathy and clarify whether it is a typical DN complicated with NDRD or not (Journal of Diabetes Research)
HbA1c variability in type 2 diabetes is associated with the occurrence of new-onset albuminuria within three years
HbA1c-CV improves 3-year prognostication of new-onset albuminuria. Together with mean HbA1c, baseline urine albumin and presence of hypertension, accurate 3-year new-onset albuminuria prognostication may be possible (Diabetes Research and Clinical Practice)
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