Incretin drugs in diabetic kidney disease: biological mechanisms and clinical evidence.

Nature Reviews. Nephrology
Radica Z AlicicKatherine R Tuttle

Abstract

As the prevalence of diabetes continues to climb, the number of individuals living with diabetic complications will reach an unprecedented magnitude. The emergence of new glucose-lowering agents - sodium-glucose cotransporter 2 inhibitors and incretin therapies - has markedly changed the treatment landscape of type 2 diabetes mellitus. In addition to effectively lowering glucose, incretin drugs, which include glucagon-like peptide 1 receptor (GLP1R) agonists and dipeptidyl peptidase 4 (DPP4) inhibitors, can also reduce blood pressure, body weight, the risk of developing or worsening chronic kidney disease and/or atherosclerotic cardiovascular events, and the risk of death. Although kidney disease events have thus far been secondary outcomes in clinical trials, an ongoing phase III trial in patients with diabetic kidney disease will test the effect of a GLP1R agonist on a primary kidney disease outcome. Experimental data have identified the modulation of innate immunity and inflammation as plausible biological mechanisms underpinning the kidney-protective effects of incretin-based agents. These drugs block the mechanisms involved in the pathogenesis of kidney damage, including the activation of resident mononuclear phagocytes, t...Continue Reading

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Citations

Feb 11, 2021·Antioxidants·Daiji KawanamiMakito Tanabe
Apr 15, 2021·Clinical Journal of the American Society of Nephrology : CJASN·Erin D Michos, Katherine R Tuttle
Jun 26, 2021·The New England Journal of Medicine·Katherine R Tuttle
Jul 3, 2021·The New England Journal of Medicine·Hertzel C GersteinUNKNOWN AMPLITUDE-O Trial Investigators
Jul 21, 2021·Nature Reviews. Nephrology·Eoin BrennanCatherine Godson
Aug 8, 2021·Nature Reviews. Nephrology·Megumi OshimaTakashi Wada
Sep 17, 2021·Cardiovascular Diabetology·Dario GiuglianoKatherine Esposito

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