Current options for slowing the progression of chronic kidney disease

Czech version

Authors: Vladimír Tesař
Authors‘ workplace: Klinika nefrologie 1. LF UK a VFN Praha
Published in: Vnitř Lék 2022; 68(7): 420-424
Category: Main Topic
doi: https://doi.org/10.36290/vnl.2022.089

Overview

From a certain stage, chronic kidney disease progresses to terminal kidney failure that requires renal replacement therapy with dialysis or transplantation. The progression can be significantly slowed by blocking the renin angiotensin aldosterone system (RAAS) with angiotensin converting enzyme (ACE) inhibitors or angiotensin II type 1 receptor blockers (ARB). Another new option to enhance the effect of blocking the RAAS system is the use of sodium glucose cotransporter 2 (SGLT2) inhibitors, or gliflozins. Dapagliflozin is currently available and reimbursed for patients with both diabetic and non-diabetic kidney disease. In the near future, treatment with the mineralocorticoid receptor inhibitor finerenone should be made available that significantly potentiates the effect of ACE or ARB inhibitors. Recent data show that it is possible to influence the progression of renal insufficiency with exercise.

Keywords:

SGLT2 – exercise – dapagliflozin – SGLT2 inhibitor – progression of chronic kidney disease – finerenone – renin angiotensin system – mineralocorticoid receptor

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