we present the available preclinical evidence supporting melatonin’s efficacy in ameliorating CKD’s pathophysiology since melatonin supplementation has not been adequately explored in patients with CKD. The combined use of stem cells with melatonin is an appealing therapeutic approach which ought to be assessed further (American Journal of Nephrology)
Diabetes News
Tag: CKD
Discovery of a Biomarker Signature That Reveals a Molecular Mechanism Underlying Diabetic Kidney Disease via Organ Cross Talk
AI-assisted discovery of the biomarker signature reveals a potential molecular mechanism underlying the complex interorgan communication occurring during DKD pathogenesis (Diabetes Care)
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
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)
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)
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)
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)
Effect of Dipeptidyl Peptidase-4 (DPP-4) Inhibition on Biomarkers of Kidney Injury and Vascular Calcification in Diabetic Kidney Disease: A Randomized Controlled Trial
Our study showed that gemigliptin significantly improved the expression of renal tubular injury biomarkers and vascular calcification levels among patients with DKD; however, gemigliptin did not affect renal function or coronary calcification compared with those observed in the control (Journal of Diabetes Research)
Performance of prediction models for nephropathy in people with type 2 diabetes: systematic review and external validation study
This study identified multiple prediction models to predict albuminuria, diabetic kidney disease, chronic kidney disease, and end stage renal disease. In the external validation, discrimination and calibration for albuminuria, diabetic kidney disease, and chronic kidney disease varied considerably across prediction horizons and models (BMJ)
Type 2 diabetes in adults: management – SGLT2 inhibitors for chronic kidney disease (update)
You can now review and comment on this draft guideline (NICE)
Chronic Kidney Disease Testing Among Primary Care Patients With Type 2 Diabetes Across 24 U.S. Health Care Organizations
While eGFR testing rates are uniformly high among people with type 2 diabetes, testing rates for uACR are suboptimal and highly variable across and within the organizations examined. Guideline-recommended uACR testing should increase detection of CKD (Diabetes Care)
Effects of canagliflozin on serum potassium in people with diabetes and chronic kidney disease: the CREDENCE trial
Among patients treated with renin–angiotensin–aldosterone system inhibitors, SGLT2 inhibition with canagliflozin may reduce the risk of hyperkalaemia in people with T2DM and CKD without increasing the risk of hypokalaemia (European Heart Journal)
Effects of Dapagliflozin in Stage 4 Chronic Kidney Disease
Among patients with stage 4 CKD and albuminuria, dapagliflozin’s benefits were consistent with those observed in the DAPA-CKD trial overall, with no evidence of increased risks (JASN)
Burden of chronic kidney disease and rapid decline in renal function among adults attending a hospital-based diabetes center in Northern Europe
DKD (using the KDIGO 2012 classification) and rapid eGFR decline were highly prevalent among adults attending a hospital-based diabetes clinic in a predominantly Caucasian Northern European country. The burden was greater for adults with type 2 diabetes. Expected as well as potentially novel clinical predictors were identified (BMJ)
Deficits in the Skeletal Muscle Transcriptome and Mitochondrial Coupling in Progressive Diabetes-Induced CKD Relate to Functional Decline
Our results indicate that T2DM-induced CKD progression impairs physical function, with implications for altered metabolic transcriptional networks and mitochondrial functional deficits as primary mechanistic factors early in CKD progression in T2DM (Diabetes)
Importance of Early Screening and Diagnosis of Chronic Kidney Disease in Patients with Type 2 Diabetes
Medications shown to slow progression of CKD include renin–angiotensin system inhibitors, sodium–glucose cotransporter-2 inhibitors, glucagon-like peptide 1 receptor agonists and, more recently, non-steroidal mineralocorticoid receptor antagonists (Diabetes Therapy)
Glucosuric, renal and hemodynamic effects of a dual inhibitor of SGLT1 and SGLT2, licogliflozin, in patients with chronic kidney disease: a randomized trial
Licogliflozin treatment results in significantly increased UGE and favorable changes in urinary electrolytes and hemodynamics in patients with varying degrees of CKD (eGFR≥45 mL/min/1.73 m2) (Diabetes, Obesity and Metabolism)
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