Papademetriou V, Alataki S, Stavropoulos K, Papadopoulos C, Bakogiannis K, Tsioufis K. Pharmacological Management of Diabetic Nephropathy.
Curr Vasc Pharmacol 2019;
18:139-147. [PMID:
30961500 DOI:
10.2174/1570161117666190405164749]
[Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Revised: 11/13/2018] [Accepted: 11/21/2018] [Indexed: 01/13/2023]
Abstract
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 antihypertensive 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.
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