Modern trends in the treatment of diabetic nephropathy

Czech version

Authors: Peter Ponťuch
Authors‘ workplace: IV. interná klinika LF UK a UNB, Nemocnica sv. Cyrila a Metoda, Bratislava
Published in: Forum Diab 2019; 8(2): 111-115
Category: Review Article

Overview

Long-term optimal glycemic control reduces the risk or slows the progression of chronic kidney disease. Some sodium-glucose cotransporter 2 inhibitors and glucagon-like peptid 1 receptor agonists have shown to reduce the risk of chronic kidney disease and cardiovascular events in patients with type 2 diabetes. Optimal control of blood pressure, based on angiotensin converting enzyme inhibitor (ACEI), or angiotensin receptor blocker (ARB), reduces the risk and slows the progression of chronic kidney disease. Dual combination of ACEI and ARB should not be given due to adverse side effects, mainly hyperkalemia and acute kidney injury. ACEI or ARB is not recommended for the primary prevention of chronic kidney disease in patients with diabetes who have normal albuminuria, normal blood pressure and normal glomerular filtration rate. Target blood pressure values should be individualized taking into account patient´s age and comorbidities. Ongoing clinical studies with finerenone and atrasentan are aimed at renal outcomes in patients with diabetes.

Keywords:

glucagon-like peptid 1 receptor agonists – renin-angiotensin system blockade – sodium-glucose cotransporter 2 inhibitors – the treatment of diabetic nephropathy

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