Review of glucagon‐like peptide‐1 receptor agonists for the treatment of type 2 diabetes mellitus in patients with chronic kidney disease and their renal effects
| العنوان: | Review of glucagon‐like peptide‐1 receptor agonists for the treatment of type 2 diabetes mellitus in patients with chronic kidney disease and their renal effects |
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| المؤلفون: | Lance Alan Sloan |
| المصدر: | Journal of Diabetes |
| بيانات النشر: | Wiley, 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | 2型糖尿病, Blood Glucose, medicine.medical_specialty, type 2 diabetes mellitus, Endocrinology, Diabetes and Metabolism, 慢性肾脏病变, Renal function, 内脏胰岛素抵抗肥胖综合征。, 030209 endocrinology & metabolism, Review Article, Disease, 糖尿病肾病, 030204 cardiovascular system & hematology, Hypoglycemia, Kidney, Incretins, Gastroenterology, Glucagon-Like Peptide-1 Receptor, 03 medical and health sciences, visceral insulin resistance adiposity syndrome, 0302 clinical medicine, Diabetes mellitus, Internal medicine, glucagon‐like peptide‐1 receptor agonist, medicine, Humans, Hypoglycemic Agents, Diabetic Nephropathies, Renal Insufficiency, Chronic, Glycemic, business.industry, Type 2 Diabetes Mellitus, medicine.disease, diabetic kidney disease, Treatment Outcome, Blood pressure, Diabetes Mellitus, Type 2, 胰高血糖素样肽‐1受体激动剂, business, chronic kidney disease, Signal Transduction, Kidney disease |
| الوصف: | Type 2 diabetes mellitus (T2DM) is the most common cause of chronic kidney disease (CKD), and when it causes CKD it is collectively referred to as diabetic kidney disease. One of the newer therapies for managing hyperglycemia is the glucagon‐like peptide‐1 receptor agonist (GLP‐1RA) drug class. This review summarizes the effects of GLP‐1RAs in patients with T2DM with CKD and evidence for renoprotection with GLP‐1RAs using data from observational studies, prospective clinical trials, post hoc analyses, and meta‐analyses. Evidence from some preclinical studies was also reviewed. Taken together, subgroup analyses of patients with varying degrees of renal function demonstrated that glycemic control with GLP‐1RAs was not markedly less effective in patients with mild or moderate renal impairment vs that in patients with normal function. GLP‐1RAs were associated with improvements in some cardiorenal risk factors, including systolic blood pressure and body weight. Furthermore, several large cardiovascular outcome studies showed reduced risks of composite renal outcomes, mostly driven by a reduction in macroalbuminuria, suggesting potential renoprotective effects of GLP‐1RAs. In conclusion, GLP‐1RAs effectively reduced hyperglycemia in patients with mild or moderately impaired kidney function in the limited number of studies to date. GLP‐1RAs may be considered in combination with other glucose‐lowering medications because of their ability to lower glucose in a glucose‐dependent manner, lowering their risk for hypoglycemia, while improving some cardiorenal risk factors. Potential renoprotective effects of GLP‐1RAs, and their renal mechanisms of action, warrant further investigation. Highlights Diabetic kidney disease is a common comorbidity of type 2 diabetes mellitus.In studies investigating the effect of renal function on the efficacy of treatment with glucagon‐like peptide‐1 receptor agonists (GLP‐1RAs), these agents improved glycemic control in patients with mild to moderately impaired kidney function, without significant differences compared with patients with normal renal function.GLP‐1RAs were associated with a lower incidence of diabetic nephropathy, mostly driven by a reduction in albuminuria, compared with placebo in several large cardiovascular outcome trials. |
| تدمد: | 1753-0407 1753-0393 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::68eb3396e31318b755dc6381569f0716Test https://doi.org/10.1111/1753-0407.12969Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....68eb3396e31318b755dc6381569f0716 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 17530407 17530393 |
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