Therapeutic Advances in Diabetic Kidney Disease
Although sodium glucose co-transporter type 2 (SGLT-2) inhibitors were initially introduced as glucose-lowering medications, it was later discovered that cardiorenal protection is the most important treatment effect of these agents. A triad of landmark trials consistently showed the benefits of SGLT...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-02-01
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| Series: | International Journal of Molecular Sciences |
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| Online Access: | https://www.mdpi.com/1422-0067/24/3/2803 |
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| author | Panagiotis I. Georgianos Vasilios Vaios Theodoros Eleftheriadis Evangelos Papachristou Vassilios Liakopoulos |
| author_facet | Panagiotis I. Georgianos Vasilios Vaios Theodoros Eleftheriadis Evangelos Papachristou Vassilios Liakopoulos |
| author_sort | Panagiotis I. Georgianos |
| collection | DOAJ |
| description | Although sodium glucose co-transporter type 2 (SGLT-2) inhibitors were initially introduced as glucose-lowering medications, it was later discovered that cardiorenal protection is the most important treatment effect of these agents. A triad of landmark trials consistently showed the benefits of SGLT-2 inhibitors on kidney and cardiovascular outcomes in patients with chronic kidney disease (CKD), irrespective of the presence or absence of Type 2 diabetes (T2D). Furthermore, finerenone is a novel, selective, nonsteroidal mineralocorticoid receptor antagonist (MRA) that safely and effectively improved cardiorenal outcomes in a large Phase 3 clinical trial program that included >13,000 patients with T2D and a wide spectrum of CKD. These two drug categories have shared and distinct mechanisms of action, generating the hypothesis that an overadditive cardiorenal benefit with their combined use may be biologically plausible. In this article, we describe the mechanism of action, and we provide an overview of the evidence for cardiorenal protection with SGLT-2 inhibitors and the nonsteroidal MRA finerenone in patients with CKD associated with T2D. |
| first_indexed | 2024-03-11T09:39:49Z |
| format | Article |
| id | doaj.art-537dfc48dc3f4a1aae479d83eacb1f88 |
| institution | Directory Open Access Journal |
| issn | 1661-6596 1422-0067 |
| language | English |
| last_indexed | 2024-03-11T09:39:49Z |
| publishDate | 2023-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | International Journal of Molecular Sciences |
| spelling | doaj.art-537dfc48dc3f4a1aae479d83eacb1f882023-11-16T17:02:25ZengMDPI AGInternational Journal of Molecular Sciences1661-65961422-00672023-02-01243280310.3390/ijms24032803Therapeutic Advances in Diabetic Kidney DiseasePanagiotis I. Georgianos0Vasilios Vaios1Theodoros Eleftheriadis2Evangelos Papachristou3Vassilios Liakopoulos42nd Department of Nephrology, AHEPA Hospital, Aristotle University of Thessaloniki, GR54636 Thessaloniki, Greece2nd Department of Nephrology, AHEPA Hospital, Aristotle University of Thessaloniki, GR54636 Thessaloniki, GreeceDepartment of Nephrology, School of Medicine, University of Thessaly, GR41110 Larissa, GreeceDepartment of Nephrology and Kidney Transplantation, University Hospital of Patras, GR26504 Patras, Greece2nd Department of Nephrology, AHEPA Hospital, Aristotle University of Thessaloniki, GR54636 Thessaloniki, GreeceAlthough sodium glucose co-transporter type 2 (SGLT-2) inhibitors were initially introduced as glucose-lowering medications, it was later discovered that cardiorenal protection is the most important treatment effect of these agents. A triad of landmark trials consistently showed the benefits of SGLT-2 inhibitors on kidney and cardiovascular outcomes in patients with chronic kidney disease (CKD), irrespective of the presence or absence of Type 2 diabetes (T2D). Furthermore, finerenone is a novel, selective, nonsteroidal mineralocorticoid receptor antagonist (MRA) that safely and effectively improved cardiorenal outcomes in a large Phase 3 clinical trial program that included >13,000 patients with T2D and a wide spectrum of CKD. These two drug categories have shared and distinct mechanisms of action, generating the hypothesis that an overadditive cardiorenal benefit with their combined use may be biologically plausible. In this article, we describe the mechanism of action, and we provide an overview of the evidence for cardiorenal protection with SGLT-2 inhibitors and the nonsteroidal MRA finerenone in patients with CKD associated with T2D.https://www.mdpi.com/1422-0067/24/3/2803cardiorenal protectionchronic kidney diseasefinerenoneSGLT-2 inhibitorsType 2 diabetes |
| spellingShingle | Panagiotis I. Georgianos Vasilios Vaios Theodoros Eleftheriadis Evangelos Papachristou Vassilios Liakopoulos Therapeutic Advances in Diabetic Kidney Disease International Journal of Molecular Sciences cardiorenal protection chronic kidney disease finerenone SGLT-2 inhibitors Type 2 diabetes |
| title | Therapeutic Advances in Diabetic Kidney Disease |
| title_full | Therapeutic Advances in Diabetic Kidney Disease |
| title_fullStr | Therapeutic Advances in Diabetic Kidney Disease |
| title_full_unstemmed | Therapeutic Advances in Diabetic Kidney Disease |
| title_short | Therapeutic Advances in Diabetic Kidney Disease |
| title_sort | therapeutic advances in diabetic kidney disease |
| topic | cardiorenal protection chronic kidney disease finerenone SGLT-2 inhibitors Type 2 diabetes |
| url | https://www.mdpi.com/1422-0067/24/3/2803 |
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