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Diabetic Nephropathy Treatment Approaches

Year 2019, Volume: 7 Issue: 3, 15 - 19, 05.04.2019

Abstract

Abstract

Similar to most of the developed countries diabetic nephropathy is the leading cause of renal failure in our country. Classical treatment for diabetic nephropathy, consistof tight glycemic control and optimization of blood pressure using renin angiotensin systeminhibitors. However, diabetic nephropathy can progress despite those measures. In therecent years, ongoing researches, revealed new patogenetic mechanism, and potentialtargets for the management of diabetic nephropathy. In this article,  we review current therapeutic options for the management of diabetic nephropathy

References

  • Kaynaklar 1.ShawJE,SicreeRA,ZimmetPZ.Globalestimatesoftheprevalenceof-dia- betes for 2010 and 2030. Diabetes Res Clin Pract 2010; 87: 4–14 2.AkmalM.Hemodialysisindiabeticpatients.AmJKidney-Dis2001;38(4 Suppl 1): S195–S199 3.Süleymanlar G, Ateş K, Seyahi N. Türkiye’de, Nefroloji-Diya-liz ve Transplantasyon. Registry 2014: Türk Nefroloji DerneğiYayınları; Miki Matbaacılık San. Ve Tic. Ltd. Şti. , Ankara, 2015 4.Sakai N, Wada T. Revisiting inflammation in diabetic nephro-pathy: the role of the Nlrp3 inflammasome in glomerular resi-dent cells. Kidney int. 2015;87: 12-14 5.Manikowski ST, Atta MG. Diabetic Kidney Disease: Pat-hophysiology and therapeutic targets. J Diabates Res 2015,http://dx.doi.org/10.1155/2015/697010 6.Nordquist L, Friederich-Persson M, Angelica F et al. Acitvati-on of Hypoxia-Inducible factors prevents diabetic nephropathy.J Am soc Nephrol 2015; 26:328-338 7.Chan GCW, Tang SCW. Diabetic nephropathy: landmark clinicaltrials and tribulations. Nephrol Dial Transplant. 2016; 31:359-369 8.UK Prospective Diabetes Study (UKPDS) Group. Intensive blo-od-glucose control with sulphonylureas or insulin compared withconventional treat- ment and risk of complications in patientswith type 2 diabetes (UKPDS 33). Lancet 1998; 352: 837–853 9.PerkovicV,HeerspinkHL,ChalmersJetal.Intensiveglucosecon-trolim- proves kidney outcomes in patients with type 2 diabetes.Kidney Int 2013; 83: 517–523 10.Gerstein HC, Miller ME, Byington RP et al. Effects of intensive glu-cose lowering in type 2 diabetes. N Engl J Med 2008; 358: 2545–2559 11.American Diabetes A. Standards of medical care in diabetes 2014.Dia- betes Care 2014; 37 (Suppl 1): S14–S80 12.Jones GC, Macklin JP, Alexander WD. Contraindications to theuse of metformin. BMJ 2003; 326: 4–5 13.Adler AI, Stratton IM, Neil HA et al. Association of systolic blo-od pressure with macrovascular and microvascular complica-tions of type 2 diabetes (UKPDS 36): prospective observatio-nal study. BMJ 2000; 321: 412–419 14.Bakris GL, Weir MR, Shanifar S et al. Effects of blood pressu-re level on progression of diabetic nephropathy: results from theRENAAL study. Arch Intern Med 2003; 163: 1555–1565 15.Viberti G, Wheeldon NM. Microalbuminuria reduction with val-sartan in patients with type 2 diabetes mellitus: a blood pres-sure-independent ef-fect. Circulation 2002; 106: 672–678 16.Andersen S, Brochner-Mortensen J, Parving HH et al. Kidneyfunction during and after withdrawal of long-term irbesartantreatment in patients with type 2 diabetes and microalbuminu-ria. Diabetes Care 2003; 26: 3296–3302 17.Lewis EJ, Hunsicker LG, Bain RP et al. The effect of angiotensin-convert- ing-enzyme inhibition on diabetic nephropathy. The Col-laborative Study Group. N Engl J Med 1993; 329: 1456–1462 18.Brenner BM, Cooper ME, de Zeeuw D et al. Effects of losar-tan on renal and cardiovascular outcomes in patients with type2 diabetes and nephro- pathy. N Engl J Med 2001; 345: 861–869 19.Martin JH, Deacon CF, Gorrell MD et al. Incretin-based the-rapies–review of the physiology, pharmacology and emergingclinical experience. Intern Med J 2011; 41: 299–307 20.Liu WJ, Xie SH, Liu YN et al. Dipeptidyl peptidase IV inhibitorattenuates kidney injury in streptozotocin-induced diabetic rats.J Pharmacol Exp Ther 2012; 340: 248–255 21.Groop PH, Cooper ME, Perkovic V et al. Linagliptin lowers al-buminuria on top of recommended standard treatment in pati-ents with type 2 dia- betes and renal dysfunction. Diabetes Care2013; 36: 3460–3468 22..Barnett AH, Mithal A, Manassie J et al. Efficacy and safety of empag-liflozin added to existing antidiabetes treatment in patients with type2 diabetes and chronic kidney disease: a randomised, double-blind,placebo- controlled trial. Lancet Diabetes Endocrinol 2014; 2: 369–384 23. Tahrani AA, Barnett AH, Bailey CJ. SGLT inhibitors in mana-gement of diabetes. Lancet Diabetes Endocrinol 2013; 1: 140–151 24. Musso G, Gambino R, Cassader M et al. A novel approach tocontrol hyperglycemia in type 2 diabetes: sodium glucose co-transport (SGLT) in- hibitors: systematic review and meta-analy-sis of randomized trials. Ann Med 2012; 44: 375–393 25.Nyirjesy P, Sobel JD, Fung A et al. Genital mycotic infectionswith cana- gliflozin, a sodium glucose co-transporter 2 inhibi-tor, in patients with type 2 diabetes mellitus: a pooled analysisof clinical studies. Curr Med Res Opin 2014; 30: 1109–1119 26.Neal B, Perkovic V, de Zeeuw D et al. Rationale, design, and ba-seline char- acteristics of the Canagliflozin Cardiovascular As-sessment Study (CAN- VAS)–a randomized placebo-controlledtrial. Am Heart J 2013; 166: 217–223 e211 27.Pergola PE, Krauth M, Huff JW et al. Effect of bardoxolonemethyl on kidney function in patients with T2D and Stage 3b-4 CKD. Am J Nephrol 2011; 33: 469–476 28.Pergola PE, Raskin P, Toto RD et al. Bardoxolone methyl and kidneyfunction in CKD with type 2 diabetes. N Engl J Med 2011; 365: 327–336 29.de Zeeuw D, Akizawa T, Audhya P et al. Bardoxolone methylin type 2 diabetes and stage 4 chronic kidney disease. N EnglJ Med 2013; 369:2492–2503 30.Himmelfarb J, Tuttle KR. New therapies for diabetic kidney di-sease. N Engl J Med 2013; 369: 2549–2550 31.Yung S, Chau MK, Zhang Q et al. Sulodexide decreases albu-minuria and regulates matrix protein accumulation in C57BL/6mice with streptozotocin-induced type I diabetic nephropathy.PLoS ONE 2013; 8: e54501 32.Gambaro G, Venturini AP, Noonan DM et al. Treatment with aglycosa- minoglycan formulation ameliorates experimental diabetic nephropathy. Kidney Int 1994; 46: 797–806 33.Packham DK, Wolfe R, Reutens AT et al. Sulodexide fails to de-monstrate renoprotection in overt type 2 diabetic nephropathy.J Am Soc Nephrol 2012; 23: 123–130 34.de Zeeuw D, Agarwal R, Amdahl M et al. Selective vitamin Dreceptor activation with paricalcitol for reduction of albuminu-ria in patients with type 2 diabetes (VITAL study): a randomi-sed controlled trial. Lancet 2010; 376: 1543–1551 35.Kohan DE, Pollock DM. Endothelin antagonists for diabetic andnon-dia- betic chronic kidney disease. Br J Clin Pharmacol 2013;76: 573–579 36.Wenzel RR, Littke T, Kuranoff S et al. Avosentan reduces albu-min excretion in diabetics with macroalbuminuria. J Am SocNephrol 2009; 20: 655–664 37.Mann JF, Green D, Jamerson K et al. Avosentan for overt dia-betic nephro- pathy. J Am Soc Nephrol 2010; 21: 527–535 38.de Zeeuw D, Coll B, Andress D et al. The endothelin antago-nist atrasentan lowers residual albuminuria in patients with type2 diabetic nephropathy. J Am Soc Nephrol 2014; 25: 1083–1093 39.de Zeeuw D, Remuzzi G, Parving HH et al. Proteinuria, a tar-get for reno- protection in patients with type 2 diabetic nephro-pathy: lessons from RE- NAAL. Kidney Int 2004; 65: 2309–2320

Diyabetik Nefropatide Tedavi Yaklaşımları

Year 2019, Volume: 7 Issue: 3, 15 - 19, 05.04.2019

Abstract

Öz

Diyabetik nefropati gelişmiş ülkelerin hemen hepsinde olduğu gibi ülkemizde de böbrek yetmezliğinin en önemli nedenidir. Klasik tedavi yaklaşımı sıkı glisemik kontrol sağlanması ve  özellikle renin anjiotensin sistemini bloke eden ilaçlar ile iyi kan basıncı regülasyonunun sağlanması şeklinde özetlenebilir. Ancak bu tedaviler optimize edilse bile bazı hastalarda diyabetik nefropatinin ilerlemesi engellenememektedir. Son yıllarda diyabetik nefropatinin  patogenezinde yeni mekanizmaların ortaya konulması, yeni tedavi yaklaşımlarının da geliştirilmesini sağlamıştır. Bu makalede güncel tedavi yaklaşılmalı gözden geçirilmiştir.

References

  • Kaynaklar 1.ShawJE,SicreeRA,ZimmetPZ.Globalestimatesoftheprevalenceof-dia- betes for 2010 and 2030. Diabetes Res Clin Pract 2010; 87: 4–14 2.AkmalM.Hemodialysisindiabeticpatients.AmJKidney-Dis2001;38(4 Suppl 1): S195–S199 3.Süleymanlar G, Ateş K, Seyahi N. Türkiye’de, Nefroloji-Diya-liz ve Transplantasyon. Registry 2014: Türk Nefroloji DerneğiYayınları; Miki Matbaacılık San. Ve Tic. Ltd. Şti. , Ankara, 2015 4.Sakai N, Wada T. Revisiting inflammation in diabetic nephro-pathy: the role of the Nlrp3 inflammasome in glomerular resi-dent cells. Kidney int. 2015;87: 12-14 5.Manikowski ST, Atta MG. Diabetic Kidney Disease: Pat-hophysiology and therapeutic targets. J Diabates Res 2015,http://dx.doi.org/10.1155/2015/697010 6.Nordquist L, Friederich-Persson M, Angelica F et al. Acitvati-on of Hypoxia-Inducible factors prevents diabetic nephropathy.J Am soc Nephrol 2015; 26:328-338 7.Chan GCW, Tang SCW. Diabetic nephropathy: landmark clinicaltrials and tribulations. Nephrol Dial Transplant. 2016; 31:359-369 8.UK Prospective Diabetes Study (UKPDS) Group. Intensive blo-od-glucose control with sulphonylureas or insulin compared withconventional treat- ment and risk of complications in patientswith type 2 diabetes (UKPDS 33). Lancet 1998; 352: 837–853 9.PerkovicV,HeerspinkHL,ChalmersJetal.Intensiveglucosecon-trolim- proves kidney outcomes in patients with type 2 diabetes.Kidney Int 2013; 83: 517–523 10.Gerstein HC, Miller ME, Byington RP et al. Effects of intensive glu-cose lowering in type 2 diabetes. N Engl J Med 2008; 358: 2545–2559 11.American Diabetes A. Standards of medical care in diabetes 2014.Dia- betes Care 2014; 37 (Suppl 1): S14–S80 12.Jones GC, Macklin JP, Alexander WD. Contraindications to theuse of metformin. BMJ 2003; 326: 4–5 13.Adler AI, Stratton IM, Neil HA et al. Association of systolic blo-od pressure with macrovascular and microvascular complica-tions of type 2 diabetes (UKPDS 36): prospective observatio-nal study. BMJ 2000; 321: 412–419 14.Bakris GL, Weir MR, Shanifar S et al. Effects of blood pressu-re level on progression of diabetic nephropathy: results from theRENAAL study. Arch Intern Med 2003; 163: 1555–1565 15.Viberti G, Wheeldon NM. Microalbuminuria reduction with val-sartan in patients with type 2 diabetes mellitus: a blood pres-sure-independent ef-fect. Circulation 2002; 106: 672–678 16.Andersen S, Brochner-Mortensen J, Parving HH et al. Kidneyfunction during and after withdrawal of long-term irbesartantreatment in patients with type 2 diabetes and microalbuminu-ria. Diabetes Care 2003; 26: 3296–3302 17.Lewis EJ, Hunsicker LG, Bain RP et al. The effect of angiotensin-convert- ing-enzyme inhibition on diabetic nephropathy. The Col-laborative Study Group. N Engl J Med 1993; 329: 1456–1462 18.Brenner BM, Cooper ME, de Zeeuw D et al. Effects of losar-tan on renal and cardiovascular outcomes in patients with type2 diabetes and nephro- pathy. N Engl J Med 2001; 345: 861–869 19.Martin JH, Deacon CF, Gorrell MD et al. Incretin-based the-rapies–review of the physiology, pharmacology and emergingclinical experience. Intern Med J 2011; 41: 299–307 20.Liu WJ, Xie SH, Liu YN et al. Dipeptidyl peptidase IV inhibitorattenuates kidney injury in streptozotocin-induced diabetic rats.J Pharmacol Exp Ther 2012; 340: 248–255 21.Groop PH, Cooper ME, Perkovic V et al. Linagliptin lowers al-buminuria on top of recommended standard treatment in pati-ents with type 2 dia- betes and renal dysfunction. Diabetes Care2013; 36: 3460–3468 22..Barnett AH, Mithal A, Manassie J et al. Efficacy and safety of empag-liflozin added to existing antidiabetes treatment in patients with type2 diabetes and chronic kidney disease: a randomised, double-blind,placebo- controlled trial. Lancet Diabetes Endocrinol 2014; 2: 369–384 23. Tahrani AA, Barnett AH, Bailey CJ. SGLT inhibitors in mana-gement of diabetes. Lancet Diabetes Endocrinol 2013; 1: 140–151 24. Musso G, Gambino R, Cassader M et al. A novel approach tocontrol hyperglycemia in type 2 diabetes: sodium glucose co-transport (SGLT) in- hibitors: systematic review and meta-analy-sis of randomized trials. Ann Med 2012; 44: 375–393 25.Nyirjesy P, Sobel JD, Fung A et al. Genital mycotic infectionswith cana- gliflozin, a sodium glucose co-transporter 2 inhibi-tor, in patients with type 2 diabetes mellitus: a pooled analysisof clinical studies. Curr Med Res Opin 2014; 30: 1109–1119 26.Neal B, Perkovic V, de Zeeuw D et al. Rationale, design, and ba-seline char- acteristics of the Canagliflozin Cardiovascular As-sessment Study (CAN- VAS)–a randomized placebo-controlledtrial. Am Heart J 2013; 166: 217–223 e211 27.Pergola PE, Krauth M, Huff JW et al. Effect of bardoxolonemethyl on kidney function in patients with T2D and Stage 3b-4 CKD. Am J Nephrol 2011; 33: 469–476 28.Pergola PE, Raskin P, Toto RD et al. Bardoxolone methyl and kidneyfunction in CKD with type 2 diabetes. N Engl J Med 2011; 365: 327–336 29.de Zeeuw D, Akizawa T, Audhya P et al. Bardoxolone methylin type 2 diabetes and stage 4 chronic kidney disease. N EnglJ Med 2013; 369:2492–2503 30.Himmelfarb J, Tuttle KR. New therapies for diabetic kidney di-sease. N Engl J Med 2013; 369: 2549–2550 31.Yung S, Chau MK, Zhang Q et al. Sulodexide decreases albu-minuria and regulates matrix protein accumulation in C57BL/6mice with streptozotocin-induced type I diabetic nephropathy.PLoS ONE 2013; 8: e54501 32.Gambaro G, Venturini AP, Noonan DM et al. Treatment with aglycosa- minoglycan formulation ameliorates experimental diabetic nephropathy. Kidney Int 1994; 46: 797–806 33.Packham DK, Wolfe R, Reutens AT et al. Sulodexide fails to de-monstrate renoprotection in overt type 2 diabetic nephropathy.J Am Soc Nephrol 2012; 23: 123–130 34.de Zeeuw D, Agarwal R, Amdahl M et al. Selective vitamin Dreceptor activation with paricalcitol for reduction of albuminu-ria in patients with type 2 diabetes (VITAL study): a randomi-sed controlled trial. Lancet 2010; 376: 1543–1551 35.Kohan DE, Pollock DM. Endothelin antagonists for diabetic andnon-dia- betic chronic kidney disease. Br J Clin Pharmacol 2013;76: 573–579 36.Wenzel RR, Littke T, Kuranoff S et al. Avosentan reduces albu-min excretion in diabetics with macroalbuminuria. J Am SocNephrol 2009; 20: 655–664 37.Mann JF, Green D, Jamerson K et al. Avosentan for overt dia-betic nephro- pathy. J Am Soc Nephrol 2010; 21: 527–535 38.de Zeeuw D, Coll B, Andress D et al. The endothelin antago-nist atrasentan lowers residual albuminuria in patients with type2 diabetic nephropathy. J Am Soc Nephrol 2014; 25: 1083–1093 39.de Zeeuw D, Remuzzi G, Parving HH et al. Proteinuria, a tar-get for reno- protection in patients with type 2 diabetic nephro-pathy: lessons from RE- NAAL. Kidney Int 2004; 65: 2309–2320
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Details

Primary Language Turkish
Journal Section Makaleler 1
Authors

Prof. Dr. Nurhan Seyahi

Publication Date April 5, 2019
Published in Issue Year 2019 Volume: 7 Issue: 3

Cite

APA Seyahi, P. D. N. (2019). Diyabetik Nefropatide Tedavi Yaklaşımları. Klinik Tıp Bilimleri, 7(3), 15-19.
AMA Seyahi PDN. Diyabetik Nefropatide Tedavi Yaklaşımları. Klinik Tıp Bilimleri. April 2019;7(3):15-19.
Chicago Seyahi, Prof. Dr. Nurhan. “Diyabetik Nefropatide Tedavi Yaklaşımları”. Klinik Tıp Bilimleri 7, no. 3 (April 2019): 15-19.
EndNote Seyahi PDN (April 1, 2019) Diyabetik Nefropatide Tedavi Yaklaşımları. Klinik Tıp Bilimleri 7 3 15–19.
IEEE P. D. N. Seyahi, “Diyabetik Nefropatide Tedavi Yaklaşımları”, Klinik Tıp Bilimleri, vol. 7, no. 3, pp. 15–19, 2019.
ISNAD Seyahi, Prof. Dr. Nurhan. “Diyabetik Nefropatide Tedavi Yaklaşımları”. Klinik Tıp Bilimleri 7/3 (April 2019), 15-19.
JAMA Seyahi PDN. Diyabetik Nefropatide Tedavi Yaklaşımları. Klinik Tıp Bilimleri. 2019;7:15–19.
MLA Seyahi, Prof. Dr. Nurhan. “Diyabetik Nefropatide Tedavi Yaklaşımları”. Klinik Tıp Bilimleri, vol. 7, no. 3, 2019, pp. 15-19.
Vancouver Seyahi PDN. Diyabetik Nefropatide Tedavi Yaklaşımları. Klinik Tıp Bilimleri. 2019;7(3):15-9.