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The protective effects of SGLT-2 inhibitors, GLP-1 receptor agonists, and RAAS blockers against renal injury in patients with type 2 diabetes

  • Nephrology - Review
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Abstract

Diabetic kidney disease is one of the most severe complications of type 2 diabetes mellitus. Patients with diabetic kidney disease have a worse prognosis in terms of mortality and morbidity, compared with patients who have diabetes alone. Strict control of blood pressure and blood glucose is the primary method for prevention of initial kidney damage and delaying further progression of existing damage. Other management approaches include the use of exogenous drugs that can effectively protect the kidneys from diabetes, such as sodium-glucose transporter 2 inhibitors, glucagon-like peptide-1 receptor agonists, and renin–angiotensin–aldosterone system blockers. These drugs may protect against kidney injury through various molecular mechanisms. This review focuses on renal impairment in patients with type 2 diabetes; it discusses the direct and indirect effects of sodium-glucose transporter 2 inhibitors, glucagon-like peptide-1 receptor agonists, and renin–angiotensin–aldosterone system blockers on diabetic kidney disease. Finally, it discusses the effects of combination treatment with two or three types of drugs in patients with chronic kidney disease.

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Funding

This work was supported by the National Natural Science Foundation of China (81870593, 82170865), Natural Science Foundation of Shandong Province of China (ZR2020MH106), Shandong Province Higher Educational Science and Technology Program for Youth Innovation (2020KJL004), Shandong Province Medical and Health Science and Technology Development Project (202003060396, 202003060400).

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Authors and Affiliations

  1. Department of Endocrinology and Metabolism, Affiliated Hospital of Weifang Medical University, 2428 Yuhe Road, Weifang, 261031, Shandong, China

    Zengguang Kuang, Ningning Hou, Chengxia Kan, Hongyan Qiu & Xiaodong Sun

  2. Branch of Shandong Provincial Clinical Research Center for Diabetes and Metabolic Diseases, Weifang, China

    Zengguang Kuang, Ningning Hou, Chengxia Kan, Hongyan Qiu & Xiaodong Sun

  3. Clinical Research Center, Affiliated Hospital of Weifang Medical University, Weifang, China

    Zengguang Kuang, Chengxia Kan, Hongyan Qiu & Xiaodong Sun

  4. Department of Pathology, Affiliated Hospital of Weifang Medical University, Weifang, China

    Fang Han

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  1. Zengguang Kuang
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  2. Ningning Hou
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  3. Chengxia Kan
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  4. Fang Han
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  5. Hongyan Qiu
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Contributions

ZK: conceptualization, methodology, data curation, and writing—original draft preparation. C K and FH: data curation and investigation. HQ, NH and XS: supervision, writing—reviewing and editing, and funding acquisition.

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Correspondence to Hongyan Qiu or Xiaodong Sun.

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Kuang, Z., Hou, N., Kan, C. et al. The protective effects of SGLT-2 inhibitors, GLP-1 receptor agonists, and RAAS blockers against renal injury in patients with type 2 diabetes. Int Urol Nephrol 55, 617–629 (2023). https://doi.org/10.1007/s11255-022-03355-6

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