Nephroprotection by Hypoglycemic Agents: Do We Have Supporting Data?

Journal of Clinical Medicine

Jose Luis Górriz³  Javier Nieto⁴  Juan F. Navarro-González²  Pablo Molina³  Alberto Martínez-Castelao¹  Luis M. Pallardó³ 

[1] Hospital Universitario Bellvitge, IDIBELL, Barcelona 08907, Spain; E-Mail:;Hospital Universitario N S Candelaria, Tenerife 38010, Spain; E-Mail:;Hospital Universitario Dr Peset, Universidad de Valencia, Valencia 46017, Spain; E-Mails:;Hospital General Universitario de Ciudad Real, 13005 Ciudad Real, Spain; E-Mail:

关键词: diabetes mellitus;    diabetic nephropathy;    diabetic chronic kidney disease;    albuminuria;    nephroprotection;    antihyperglycemic drugs;    SGLT2 inhibition;    albuminuria;    DDP4 inhibitors;    glucagon-like peptide agonists;   

DOI  :  10.3390/jcm4101866

来源: mdpi

【 摘 要 】

Current therapy directed at delaying the progression of diabetic nephropathy includes intensive glycemic and optimal blood pressure control, renin angiotensin-aldosterone system blockade and multifactorial intervention. However, the renal protection provided by these therapeutic modalities is incomplete. There is a scarcity of studies analysing the nephroprotective effect of antihyperglycaemic drugs beyond their glucose lowering effect and improved glycaemic control on the prevention and progression of diabetic nephropathy. This article analyzes the exisiting data about older and newer drugs as well as the mechanisms associated with hypoglycemic drugs, apart from their well known blood glucose lowering effect, in the prevention and progression of diabetic nephropathy. Most of them have been tested in humans, but with varying degrees of success. Although experimental data about most of antihyperglycemic drugs has shown a beneficial effect in kidney parameters, there is a lack of clinical trials that clearly prove these beneficial effects. The key question, however, is whether antihyperglycemic drugs are able to improve renal end-points beyond their antihyperglycemic effect. Existing experimental data are post hoc studies from clinical trials, and supportive of the potential renal-protective role of some of them, especially in the cases of dipeptidyl peptidase-4 inhibitors, glucagon-like peptide-1 receptor agonists and sodium-glucose cotransporter 2 inhibitors. Dedicated and adequately powered renal trials with renal outcomes are neccessary to assess the nephrotection of antihyperglycaemic drugs beyond the control of hyperglycaemia.

【 授权许可】

CC BY   
© 2015 by the authors; licensee MDPI, Basel, Switzerland.