Which drug is prevention progression of renal damage in diabetic patients?
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FDA has approved Kerendia (finerenone) tablets to reduce the risk of kidney function decline, kidney failure, cardiovascular death, non-fatal heart attacks, and hospitalization for heart failure in adults with chronic kidney disease associated with type 2 diabetes. Show Diabetes is the leading cause of chronic kidney disease and kidney failure in the United States. Chronic kidney disease occurs when the kidneys are damaged and cannot filter blood normally. Because of defective filtering, patients can have complications related to fluid, electrolytes (minerals required for many bodily processes), and waste build-up in the body. Chronic kidney disease sometimes can progress to kidney failure. Patients also are at high risk of heart disease. The efficacy of Kerendia to improve kidney and heart outcomes was evaluated in a randomized, multicenter, double-blind, placebo-controlled study in adults with chronic kidney disease associated with type 2 diabetes. In this study, 5,674 patients were randomly assigned to receive either Kerendia or a placebo. The study compared the two groups for the number of patients whose disease progressed to a composite (or combined) endpoint that included at least a 40% reduction in kidney function, progression to kidney failure, or kidney death. Results showed that 504 of the 2,833 patients who received Kerendia had at least one of the events in the composite endpoint compared to 600 of the 2,841 patients who received a placebo. The study also compared the two groups for the number of patients who experienced cardiovascular death, a non-fatal heart attack, non-fatal stroke, or hospitalization for heart failure. Results showed that 367 of the 2,833 patients receiving Kerendia had at least one of the events in the composite endpoint compared to 420 of the 2,841 patients who received a placebo, with the treatment showing a reduction in the risk of cardiovascular death, non-fatal heart attack, and hospitalization for heart failure. Side effects of Kerendia include hyperkalemia (high levels of potassium), hypotension (low blood pressure), and hyponatremia (low levels of sodium). Patients with adrenal insufficiency (when the body does not produce enough of certain hormones) and those receiving simultaneous treatment with strong CYP3A4 inhibitors should not take Kerendia. Diabetic kidney disease (DKD) is not only one of the main complications of diabetes, but also the leading cause of the end-stage renal disease (ESRD). The occurrence and development of DKD have always been a serious clinical problem that leads to the increase of morbidity and mortality and the severe damage to the quality of life of human beings. Controlling blood glucose, blood pressure, blood lipids, and improving lifestyle can help slow the progress of DKD. In recent years, with the extensive research on the pathological mechanism and molecular mechanism of DKD, there are more and more new drugs based on this, such as new hypoglycemic drugs sodium-glucose cotransporter 2 (SGLT2) inhibitors, glucagon-like peptide-1 (GLP-1) inhibitors, and dipeptidyl peptidase-4 (DPP-4) inhibitors with good efficacy in clinical treatment. Besides, there are some newly developed drugs, including protein kinase C (PKC) inhibitors, advanced glycation end product (AGE) inhibitors, aldosterone receptor inhibitors, endothelin receptor (ETR) inhibitors, transforming growth factor-β (TGF-β) inhibitors, Rho kinase (ROCK) inhibitors and so on, which show positive effects in animal or clinical trials and bring hope for the treatment of DKD. In this review, we sort out the progress in the treatment of DKD in recent years, the research status of some emerging drugs, and the potential drugs for the treatment of DKD in the future, hoping to provide some directions for clinical treatment of DKD. Graphical AbstractThe drugs treatment of diabetic nephropathy. Abbreviations: GLP-1, glucagon-like peptide-1; DPP-4, dipeptidyl peptidase-4; SGLT 2, sodium-glucose cotransporter 2; ROCK, Rho kinase; PKC, protein kinase C; AGEs, advanced glycation end-products; PDEIs, phosphodiesterase Inhibitors; ASK1, apoptosis signal-regulating kinase 1; UACR, urine albumin to creatinine ratio; UAER, urinary albumin excretion rate; eGFR, estimated glomerular filtration rate. 
AbbreviationsDKD diabetic kidney disease CKD chronic kidney disease DM diabetes mellitus GFR glomerular filtration rate ESRD end-stage renal disease IDF international diabetes federation RAAS renin-angiotensin-aldosterone system SGLT2 sodium-glucose cotransporter 2 GLP-1 glucagon-like peptide-1 DPP-4 dipeptidyl peptidase-4 PKC protein kinase C AGE advanced glycation end-products ET Endothelin VDR vitamin D receptor FDA food and drug administration RCTs randomized controlled trials EMT epithelial-mesenchymal transition ECM extracellular matrix OS oxidative stress ROS reactive oxygen species TGF-β transforming growth factor-β VEGF vascular endothelial growth factor NF-κB nuclear factor kappa-B JAK-STAT Janus kinase/signal transducers and activators of transcription CVDs cardiovascular diseases eGFR estimated glomerular filtration rate ADA American Diabetes Association EASD European Association for the Study of Diabetes , angiotensin-converting enzyme inhibitors KDOQI，Kidney Disease Outcomes Quality Initiative；ACEIs ARBs angiotensin II receptor blockers AKI acute kidney injury UACR urine albumin to creatinine ratio LDL-C low-density lipoprotein cholesterol ASCVD arteriosclerotic cardiovascular diseases T2DM type 2 diabetes mellitus HF heart failure HFpEF HF preserved ejection fraction HFrEF HF reduced ejection fraction CREDENCE Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation EMPA-REG OUTCOME Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes DECLARE Dapagliflozin effect on cardiovascular events DECLARE-TIMI 58 Dapagliflozin Effect on Cardiovascular Events-Thrombolysis in Myocardial Infarction 58 CANVAS Canagliflozin Cardiovascular Assessment Study CANVAS-R Canagliflozin Cardiovascular Assessment Study-Renal LEADER Liraglutide Effect and Action in Diabetes: Evaluation of CV Outcome Results ELIXA Evaluation of Lixisenatide in Acute Coronary Syndrome SAVOR-TIMI 53 Saxagliptin Assessment of Vascular Outcomes Recorded in Patients with Diabetes Mellitus-Thrombolysis in Myocardial Infarction 53 TECOS Trial Evaluating Cardiovascular Outcomes with Sitagliptin MRs mineralocorticoid receptors MRAs mineralocorticoid receptor antagonists FIGARO-DKD Finerenone in reducing kidney failure and disease progression in Diabetic Kidney Disease PREDIAN Pentoxifylline for Renoprotection in Diabetic kidney disease PENFOSIDINE STUDY Pentoxifylline Effect in Patients With Diabetic Nephropathy ERA ET receptor A ERB ET receptor B Nrf2 nuclear factor erythroid-derived 2-related factor 2 CTGF connective tissue growth factor MMP matrix metalloproteinases ASK1 apoptosis signal-regulating kinase 1 MCP-1/CCL2 monocyte chemoattractant protein-1 Ang Ⅱ angiotensin Ⅱ TNF-α tumor necrosis factor IL-1 interleukin-1 ROCK Rho kinase NA not applicable RAS renin-angiotensin system NADPH,nicotinamide adenine dinucleotide phosphatase EMPA-KIDNEY The Study of Heart and Kidney Protection With Empagliflozin PADA-CKD A Study to Evaluate the Effect of Dapagliflozin on Renal Outcomes and Cardiovascular Mortality in Patients With Chronic Kidney Disease Which drug is found to prevent progression of renal damage in diabetic patients?The drug, canagliflozin, improves on a nearly two-decades-old therapy that is currently the only treatment approved to protect kidney function in people with Type 2 diabetes. In the trial, canagliflozin also was found to reduce the risk of major cardiovascular events.
What diabetic medications are used for renal protection?Diabetes drugs that have shown to have evidence in reducing chronic kidney disease progression for people that have both diabetes and kidney disease are:. canagliflozin.. empagliflozin.. dapagliflozin.. liraglutide.. semaglutide.. dulaglutide.. What medication is used to slow the progression of CKD?ACE inhibitors and ARBs have been shown to slow the progression of CKD, particularly in patients with albuminuria. These medications lower glomerular capillary blood pressure as well as systemic blood pressure.
Which drug is commonly used in renal dysfunction?Drugs used to treat Renal Failure. |
