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Advances in the Pharmacological Management of Diabetic Nephropathy: A 2022 International Update
Diabetic nephropathy (DN) is the leading cause of end-stage renal disease (ESRD) worldwide. Its pathogenesis encompasses functional alterations involving elevated intraglomerular and systemic pressure, increased activity of the renin-angiotensin system (RAS) and oxidative stress, and the eventual de...
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| Published in: | Biomedicines 2023-01, Vol.11 (2), p.291 |
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| creator | Giglio, Rosaria Vincenza Patti, Angelo Maria Rizvi, Ali Abbas Stoian, Anca Panta Ciaccio, Marcello Papanas, Nikolaos Janez, Andrej Sonmez, Alper Banach, Maciej Sahebkar, Amirhossein Rizzo, Manfredi |
| description | Diabetic nephropathy (DN) is the leading cause of end-stage renal disease (ESRD) worldwide. Its pathogenesis encompasses functional alterations involving elevated intraglomerular and systemic pressure, increased activity of the renin-angiotensin system (RAS) and oxidative stress, and the eventual development of renal fibrosis. The management of DN involves the optimization of blood pressure (BP) and blood glucose targets. However, treatment of these risk factors slows down but does not stop the progression of DN. Innovative pharmacologic therapies for dyslipidemia and type 2 diabetes mellitus (T2DM) could play a key role in bridging this gap and attenuating the residual risk of DN beyond traditional risk factor management. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), sodium-glucose cotransporter-2 inhibitors (SGLT-2is), and inhibitors of mineralocorticoid receptor-mediated sodium reabsorption are recently introduced drug classes that have been shown to have positive effects on kidney function in individuals with T2DM. The aim of this review is to provide an update on the therapeutic options available in order to prevent or slow the onset and progression of DN in diabetic patients. |
| doi_str_mv | 10.3390/biomedicines11020291 |
| format | article |
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Its pathogenesis encompasses functional alterations involving elevated intraglomerular and systemic pressure, increased activity of the renin-angiotensin system (RAS) and oxidative stress, and the eventual development of renal fibrosis. The management of DN involves the optimization of blood pressure (BP) and blood glucose targets. However, treatment of these risk factors slows down but does not stop the progression of DN. Innovative pharmacologic therapies for dyslipidemia and type 2 diabetes mellitus (T2DM) could play a key role in bridging this gap and attenuating the residual risk of DN beyond traditional risk factor management. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), sodium-glucose cotransporter-2 inhibitors (SGLT-2is), and inhibitors of mineralocorticoid receptor-mediated sodium reabsorption are recently introduced drug classes that have been shown to have positive effects on kidney function in individuals with T2DM. The aim of this review is to provide an update on the therapeutic options available in order to prevent or slow the onset and progression of DN in diabetic patients.</description><identifier>ISSN: 2227-9059</identifier><identifier>EISSN: 2227-9059</identifier><identifier>DOI: 10.3390/biomedicines11020291</identifier><identifier>PMID: 36830828</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Angiotensin ; Blood pressure ; cardiovascular risk ; Creatinine ; Diabetes ; diabetes mellitus ; Diabetes mellitus (non-insulin dependent) ; Diabetic nephropathies ; Diabetic retinopathy ; Disease prevention ; Drug therapy ; Dyslipidemia ; End-stage renal disease ; Endocrine system ; Fibrosis ; Glucagon ; Glucagon-like peptide 1 ; Glucose ; Hemodynamics ; Hyperglycemia ; Hypertension ; innovative therapy ; Insulin resistance ; kidney disease ; Kidney diseases ; kidney protection ; Medical innovations ; Nephropathy ; Nonsteroidal anti-inflammatory drugs ; Oxidative stress ; Pathogenesis ; Peptides ; Reabsorption ; Renin ; Review ; Risk factors ; Weight control</subject><ispartof>Biomedicines, 2023-01, Vol.11 (2), p.291</ispartof><rights>COPYRIGHT 2023 MDPI AG</rights><rights>2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). 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Its pathogenesis encompasses functional alterations involving elevated intraglomerular and systemic pressure, increased activity of the renin-angiotensin system (RAS) and oxidative stress, and the eventual development of renal fibrosis. The management of DN involves the optimization of blood pressure (BP) and blood glucose targets. However, treatment of these risk factors slows down but does not stop the progression of DN. Innovative pharmacologic therapies for dyslipidemia and type 2 diabetes mellitus (T2DM) could play a key role in bridging this gap and attenuating the residual risk of DN beyond traditional risk factor management. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), sodium-glucose cotransporter-2 inhibitors (SGLT-2is), and inhibitors of mineralocorticoid receptor-mediated sodium reabsorption are recently introduced drug classes that have been shown to have positive effects on kidney function in individuals with T2DM. The aim of this review is to provide an update on the therapeutic options available in order to prevent or slow the onset and progression of DN in diabetic patients.</description><subject>Angiotensin</subject><subject>Blood pressure</subject><subject>cardiovascular risk</subject><subject>Creatinine</subject><subject>Diabetes</subject><subject>diabetes mellitus</subject><subject>Diabetes mellitus (non-insulin dependent)</subject><subject>Diabetic nephropathies</subject><subject>Diabetic retinopathy</subject><subject>Disease prevention</subject><subject>Drug therapy</subject><subject>Dyslipidemia</subject><subject>End-stage renal disease</subject><subject>Endocrine system</subject><subject>Fibrosis</subject><subject>Glucagon</subject><subject>Glucagon-like peptide 1</subject><subject>Glucose</subject><subject>Hemodynamics</subject><subject>Hyperglycemia</subject><subject>Hypertension</subject><subject>innovative therapy</subject><subject>Insulin resistance</subject><subject>kidney disease</subject><subject>Kidney diseases</subject><subject>kidney protection</subject><subject>Medical innovations</subject><subject>Nephropathy</subject><subject>Nonsteroidal anti-inflammatory drugs</subject><subject>Oxidative stress</subject><subject>Pathogenesis</subject><subject>Peptides</subject><subject>Reabsorption</subject><subject>Renin</subject><subject>Review</subject><subject>Risk factors</subject><subject>Weight control</subject><issn>2227-9059</issn><issn>2227-9059</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNptkk1v1DAQhiMEolXpP0AoEhcuWxzbiTMckFbla6XycaBna-yMs14l9uJkK_Xf42VL6aLaB1vj9308M5qieFmxCyGAvTU-jtR56wNNVcU441A9KU4552oBrIanD-4nxfk0bVheUIm2ks-LE9G0grW8PS30srvBYGkqfSjnNZU_1phGtHGIvbc4lF8xYE8jhbmMrvzg0dDsbfmNtusUtzivb9-VyzInwMtVmCkFnH0M2Xi97XCmF8Uzh8NE53fnWXH96ePPyy-Lq--fV5fLq4WtG5gXRiAwyU1T1w4IGjAInZEC2lqirS1zXcdRKDSVMZIBNFxADaqTnIxjTpwVqwO3i7jR2-RHTLc6otd_AjH1GlNOfCANlohb6kgiSWd5C0ZZ2zpVYyUbyzLr_YG13ZncZZtrTzgcQY9fgl_rPt5ogFpIaDLgzR0gxV87mmY9-snSMGCguJs0Vy1jStRKZenr_6SbuMtNHPYqBVIopvg_VY-5AB9czP_aPVQvleSVErJts-riEVXeHY3exkDO5_iRQR4MNsVpSuTua6yY3s-ZfmzOsu3Vw_7cm_5OlfgNsMzQqw</recordid><startdate>20230120</startdate><enddate>20230120</enddate><creator>Giglio, Rosaria Vincenza</creator><creator>Patti, Angelo Maria</creator><creator>Rizvi, Ali Abbas</creator><creator>Stoian, Anca Panta</creator><creator>Ciaccio, Marcello</creator><creator>Papanas, Nikolaos</creator><creator>Janez, Andrej</creator><creator>Sonmez, Alper</creator><creator>Banach, Maciej</creator><creator>Sahebkar, Amirhossein</creator><creator>Rizzo, Manfredi</creator><general>MDPI AG</general><general>MDPI</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>8FE</scope><scope>8FH</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>LK8</scope><scope>M7P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-3714-0790</orcidid><orcidid>https://orcid.org/0000-0002-9309-7715</orcidid><orcidid>https://orcid.org/0000-0002-9549-8504</orcidid><orcidid>https://orcid.org/0000-0003-0555-526X</orcidid><orcidid>https://orcid.org/0000-0001-6120-9041</orcidid><orcidid>https://orcid.org/0000-0001-6690-6874</orcidid><orcidid>https://orcid.org/0000-0002-8656-1444</orcidid><orcidid>https://orcid.org/0000-0002-6594-5254</orcidid><orcidid>https://orcid.org/0000-0002-7320-785X</orcidid></search><sort><creationdate>20230120</creationdate><title>Advances in the Pharmacological Management of Diabetic Nephropathy: A 2022 International Update</title><author>Giglio, Rosaria Vincenza ; Patti, Angelo Maria ; Rizvi, Ali Abbas ; Stoian, Anca Panta ; Ciaccio, Marcello ; Papanas, Nikolaos ; Janez, Andrej ; Sonmez, Alper ; Banach, Maciej ; Sahebkar, Amirhossein ; Rizzo, Manfredi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c569t-b3a9042b655f9e969ba9db439854ac5c0fdd2a37ab1bb40996239597d42ebf0f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Angiotensin</topic><topic>Blood pressure</topic><topic>cardiovascular risk</topic><topic>Creatinine</topic><topic>Diabetes</topic><topic>diabetes mellitus</topic><topic>Diabetes mellitus (non-insulin dependent)</topic><topic>Diabetic nephropathies</topic><topic>Diabetic retinopathy</topic><topic>Disease prevention</topic><topic>Drug therapy</topic><topic>Dyslipidemia</topic><topic>End-stage renal disease</topic><topic>Endocrine system</topic><topic>Fibrosis</topic><topic>Glucagon</topic><topic>Glucagon-like peptide 1</topic><topic>Glucose</topic><topic>Hemodynamics</topic><topic>Hyperglycemia</topic><topic>Hypertension</topic><topic>innovative therapy</topic><topic>Insulin resistance</topic><topic>kidney disease</topic><topic>Kidney diseases</topic><topic>kidney protection</topic><topic>Medical innovations</topic><topic>Nephropathy</topic><topic>Nonsteroidal anti-inflammatory drugs</topic><topic>Oxidative stress</topic><topic>Pathogenesis</topic><topic>Peptides</topic><topic>Reabsorption</topic><topic>Renin</topic><topic>Review</topic><topic>Risk factors</topic><topic>Weight control</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Giglio, Rosaria Vincenza</creatorcontrib><creatorcontrib>Patti, Angelo Maria</creatorcontrib><creatorcontrib>Rizvi, Ali Abbas</creatorcontrib><creatorcontrib>Stoian, Anca Panta</creatorcontrib><creatorcontrib>Ciaccio, Marcello</creatorcontrib><creatorcontrib>Papanas, Nikolaos</creatorcontrib><creatorcontrib>Janez, Andrej</creatorcontrib><creatorcontrib>Sonmez, Alper</creatorcontrib><creatorcontrib>Banach, Maciej</creatorcontrib><creatorcontrib>Sahebkar, Amirhossein</creatorcontrib><creatorcontrib>Rizzo, Manfredi</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Biological Science Database</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>Directory of Open Access Journals</collection><jtitle>Biomedicines</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Giglio, Rosaria Vincenza</au><au>Patti, Angelo Maria</au><au>Rizvi, Ali Abbas</au><au>Stoian, Anca Panta</au><au>Ciaccio, Marcello</au><au>Papanas, Nikolaos</au><au>Janez, Andrej</au><au>Sonmez, Alper</au><au>Banach, Maciej</au><au>Sahebkar, Amirhossein</au><au>Rizzo, Manfredi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Advances in the Pharmacological Management of Diabetic Nephropathy: A 2022 International Update</atitle><jtitle>Biomedicines</jtitle><addtitle>Biomedicines</addtitle><date>2023-01-20</date><risdate>2023</risdate><volume>11</volume><issue>2</issue><spage>291</spage><pages>291-</pages><issn>2227-9059</issn><eissn>2227-9059</eissn><abstract>Diabetic nephropathy (DN) is the leading cause of end-stage renal disease (ESRD) worldwide. Its pathogenesis encompasses functional alterations involving elevated intraglomerular and systemic pressure, increased activity of the renin-angiotensin system (RAS) and oxidative stress, and the eventual development of renal fibrosis. The management of DN involves the optimization of blood pressure (BP) and blood glucose targets. However, treatment of these risk factors slows down but does not stop the progression of DN. Innovative pharmacologic therapies for dyslipidemia and type 2 diabetes mellitus (T2DM) could play a key role in bridging this gap and attenuating the residual risk of DN beyond traditional risk factor management. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), sodium-glucose cotransporter-2 inhibitors (SGLT-2is), and inhibitors of mineralocorticoid receptor-mediated sodium reabsorption are recently introduced drug classes that have been shown to have positive effects on kidney function in individuals with T2DM. The aim of this review is to provide an update on the therapeutic options available in order to prevent or slow the onset and progression of DN in diabetic patients.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>36830828</pmid><doi>10.3390/biomedicines11020291</doi><orcidid>https://orcid.org/0000-0002-3714-0790</orcidid><orcidid>https://orcid.org/0000-0002-9309-7715</orcidid><orcidid>https://orcid.org/0000-0002-9549-8504</orcidid><orcidid>https://orcid.org/0000-0003-0555-526X</orcidid><orcidid>https://orcid.org/0000-0001-6120-9041</orcidid><orcidid>https://orcid.org/0000-0001-6690-6874</orcidid><orcidid>https://orcid.org/0000-0002-8656-1444</orcidid><orcidid>https://orcid.org/0000-0002-6594-5254</orcidid><orcidid>https://orcid.org/0000-0002-7320-785X</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Angiotensin Blood pressure cardiovascular risk Creatinine Diabetes diabetes mellitus Diabetes mellitus (non-insulin dependent) Diabetic nephropathies Diabetic retinopathy Disease prevention Drug therapy Dyslipidemia End-stage renal disease Endocrine system Fibrosis Glucagon Glucagon-like peptide 1 Glucose Hemodynamics Hyperglycemia Hypertension innovative therapy Insulin resistance kidney disease Kidney diseases kidney protection Medical innovations Nephropathy Nonsteroidal anti-inflammatory drugs Oxidative stress Pathogenesis Peptides Reabsorption Renin Review Risk factors Weight control |
| title | Advances in the Pharmacological Management of Diabetic Nephropathy: A 2022 International Update |
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