Potential kidney protective effects of glucagon-like peptide-1 receptor agonists

被引:6
作者
Trevella, Philippa [1 ]
Ekinci, Elif I. [2 ,3 ,4 ]
Macisaac, Richard J. [1 ,4 ,5 ]
机构
[1] St Vincents Hosp Melbourne, Dept Endocrinol & Diabet, Fitzroy, Vic, Australia
[2] Austin Hlth, Dept Endocrinol, Melbourne, Vic, Australia
[3] Austin Hlth, Melbourne Med Sch, Dept Med, Parkville, Vic, Australia
[4] Univ Melbourne, Australian Ctr Accelerating Diabet Innovat, Sch Med, Parkville, Vic, Australia
[5] Univ Melbourne, St Vincents Hosp Melbourne, Dept Med, Fitzroy, Vic, Australia
基金
英国医学研究理事会;
关键词
albuminuria; diabetes; diabetic nephropathy; glucagon-like peptide-1 receptor agonists; kidney; CARDIOVASCULAR OUTCOMES; ORAL SEMAGLUTIDE; BLOOD-PRESSURE; HEART-RATE; TYPE-2; DISEASE; IMPACT; RISK; LIRAGLUTIDE; EXENATIDE;
D O I
10.1111/nep.14336
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have gained increasing attention for their potential benefits in people with type 2 diabetes (T2DM) with chronic kidney disease (CKD). This class of medication has demonstrated promising results in reducing albuminuria, preserving estimated glomerular filtration rate (eGFR), and mitigating cardiovascular (CV) risk, making them potential therapeutic options for individuals with CKD. The kidney protective effects of GLP-1RAs extend beyond glycaemic control, and are thought to be attributed to their anti-inflammatory, antioxidant, and natriuretic properties. Despite these promising findings, the use of GLP-RAs has yet to be definitively shown to slow progression to chronic kidney failure, or reduce CV and kidney related death in people with T2DM and CKD. The Research Study to See How Semaglutide (a once weekly subcutaneous administered GLP-1RA) Works Compared to Placebo in People with Type 2 Diabetes and Chronic Kidney Disease (FLOW trial) was recently stopped because of efficacy. The primary end point for the FLOW trial consists of a composite endpoint of (i) onset of chronic kidney failure; (ii) death from kidney failure; (iii) cardiovascular death; and (iv) onset of a persistent >= 50% reduction in eGFR from baseline. It has also been reported by the sponsors of the trial that the primary end point of the trial was reduced by 24% with both CKD and CV outcomes contributing to risk reduction. In anticipation of the results of the FLOW trial being published, we review the current evidence surrounding kidney outcomes and proposed kidney protective pathways associated with GLP-1RA use. In anticipation of the results of a dedicated kidney outcome study of the GLP-1RA semaglutide in people with type 2 diabetes and established chronic kidney disease (the FLOW trial) being released sometime in 2024, here we review the current evidence surrounding kidney outcomes and proposed kidney protective pathways associated with GLP-1RA use.
引用
收藏
页码:457 / 469
页数:13
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