The New Era for Reno-Cardiovascular Treatment in Type 2 Diabetes
García-Carro, Clara (Hospital Universitari Vall d'Hebron)
Vergara, Ander (Vall d'Hebron Institut de Recerca (VHIR))
Agraz Pamplona, Irene (Vall d'Hebron Institut de Recerca (VHIR))
Jacobs-Cachá, Conxita (Vall d'Hebron Institut de Recerca (VHIR))
Espinel Garuz, Eugenia (Vall d'Hebron Institut de Recerca (VHIR))
Seron, Daniel (Vall d'Hebron Institut de Recerca (VHIR))
Soler, María José (Vall d'Hebron Institut de Recerca (VHIR))
Universitat Autònoma de Barcelona

Date:	2019
Abstract:	Diabetic kidney disease (DKD) is the leading cause of end-stage renal disease in the developed world. Until 2016, the only treatment that was clearly demonstrated to delay the DKD was the renin-angiotensin system blockade, either by angiotensin-converting enzyme inhibitors or angiotensin receptor blockers. However, this strategy only partially covered the DKD progression. Thus, new strategies for reno-cardiovascular protection in type 2 diabetic patients are urgently needed. In the last few years, hypoglycaemic drugs, such as sodium-glucose co-transporter 2 inhibitors and glucagon-like peptide-1 receptor agonists, demonstrated a cardioprotective effect, mainly in terms of decreasing hospitalization for heart failure and cardiovascular death in type 2 diabetic patients. In addition, these drugs also demonstrated a clear renoprotective effect by delaying DKD progression and decreasing albuminuria. Another hypoglycaemic drug class, dipeptidyl peptidase 4 inhibitors, has been approved for its use in patients with advanced chronic kidney disease, avoiding, in part, the need for insulinization in this group of DKD patients. Studies in diabetic and non-diabetic experimental models suggest that these drugs may exert their reno-cardiovascular protective effect by glucose and non-glucose dependent mechanisms. This review focuses on newly demonstrated strategies that have shown reno-cardiovascular benefits in type 2 diabetes and that may change diabetes management algorithms.
Grants:	Ministerio de Economía y Competitividad RD16/0009/0030 Instituto de Salud Carlos III PI17/00257
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Diabetes ; Diabetic kidney disease ; Reno-cardiovascular protection ; Sodium-glucose co-transporter 2 inhibitors ; Glucagon-like peptide-1 receptor agonists ; Dipeptidyl peptidase 4 inhibitors
Published in:	Journal of clinical medicine, Vol. 8 (june 2019) , ISSN 2077-0383

DOI: 10.3390/jcm8060864
PMID: 31212945

16 p, 1.1 MB

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