Τίτλος:
Pharmacological management of diabetic nephropathy
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Introduction: Diabetes mellitus (DM) is one of the most common diseases worldwide. Its adverse effects on several body organs, have made treatment of DM a priority. One of the most serious complications of DM is diabetic nephropathy (DN). Objective: The aim of this review is to critically discuss available data on the pharmacological management of DN. Methods: A comprehensive review of the literature was performed to identify studies assessing the impact of several drug classes on DN. Results: Several studies have been conducted in order to find a novel and effective treatment of DN. So far, the cornerstone therapy of DN consists of renin-angiotensin system (RAS) inhibitors, agents that decrease the synthesis of intrarenal angiotensin II or block its receptors. Their antiproteinuric and anti-hypertensive effects can not only decelerate the progress of DN but prevent its onset as well. Novel antidiabetic drugs, such as sodium-glucose cotransporter 2 inhibitors (SGLT-2i) and glucagon-like peptide-1 receptor agonists (GLP-1 RA), are promising agents in the therapy of DN, due to their positive effect on renal and cardiovascular adverse events. From lipid-lowering agents, atorvastatin improves DN up to stage 3 and substantially reduces CVD. Conclusion: RAS inhibitors, SGLT-2i and GLP-1 agonists were found to be beneficial for the treatment of DN. Larger renal trials are needed in order to incorporate these drugs into the first line treatment of DN. © 2020 Bentham Science Publishers.
Συγγραφείς:
Papademetriou, V.
Alataki, S.
Stavropoulos, K.
Papadopoulos, C.
Bakogiannis, K.
Tsioufis, K.
Περιοδικό:
Current Vascular Pharmacology
Εκδότης:
Bentham Science Publishers
Λέξεις-κλειδιά:
albiglutide; alirocumab; atorvastatin; atrasentan; avosentan; calcium channel stimulating agent; canagliflozin; captopril; dapagliflozin; dihydropyridine; empagliflozin; enalapril; endothelin 1 derivative; evolocumab; exendin 4; fenofibrate; glucagon like peptide receptor agonist; hydroxymethylglutaryl coenzyme A reductase inhibitor; irbesartan; liraglutide; losartan; placebo; ramipril; renin inhibitor; rosuvastatin; simvastatin; sodium glucose cotransporter 2 inhibitor; taspoglutide; telmisartan; thiazide diuretic agent; unindexed drug; angiotensin receptor antagonist; antidiabetic agent; antilipemic agent; dipeptidyl carboxypeptidase inhibitor; GLP1R protein, human; glucagon like peptide 1 receptor; incretin, acute coronary syndrome; acute heart infarction; albuminuria; blood glucose monitoring; blood pressure monitoring; cardiovascular mortality; cardiovascular risk; diabetes mellitus; diabetic nephropathy; diastolic blood pressure; drug mechanism; end stage renal disease; fluid retention; glomerulus filtration rate; glucose blood level; hemodialysis; human; hyperkalemia; hypertension; kidney function; kidney injury; kidney tubule; lifestyle modification; microalbuminuria; phase 3 clinical trial (topic); renal protection; renin angiotensin aldosterone system; Review; severe renal impairment; systolic blood pressure; urea nitrogen blood level; urinary excretion; animal; diabetes mellitus; diabetic nephropathy; drug effect; kidney; pathophysiology; treatment outcome, Angiotensin Receptor Antagonists; Angiotensin-Converting Enzyme Inhibitors; Animals; Diabetes Mellitus; Diabetic Nephropathies; Glucagon-Like Peptide-1 Receptor; Humans; Hypoglycemic Agents; Hypolipidemic Agents; Incretins; Kidney; Renin-Angiotensin System; Sodium-Glucose Transporter 2 Inhibitors; Treatment Outcome
DOI:
10.2174/1570161117666190405164749
