Batu Demir Duygu, Cooper Mark E
aDiabetes Domain, Baker IDI Heart and Diabetes Institute bDepartment of Medicine, Central Clinical School, Monash University cDepartment of Endocrinology and Diabetes, Alfred Health, Melbourne, Victoria, Australia.
Curr Opin Nephrol Hypertens. 2016 Jul;25(4):348-54. doi: 10.1097/MNH.0000000000000234.
The purpose of this review is to provide an overview of recent preclinical and clinical studies, which demonstrate new insights for the treatment of diabetic kidney disease (DKD) and to outline future directions with respect to novel therapies.
Positive findings with respect to new glucose-lowering agents such as sodium-dependent glucose transporter 2 inhibitors may lead to a change in the way we treat diabetic individuals with or at risk of DKD. Additional positive phase 2 clinical studies with drugs that have hemodynamic actions such as endothelin antagonists and mineralocorticoid receptor antagonists have led to larger phase 3 trials with atrasentan and finerenone, respectively, in order to address if these drugs indeed delay the development of end-stage renal disease. A number of other pathways are currently under active preclinical investigation and hopefully over the next decade will lead to promising drug candidates for subsequent clinical trials.
DKD remains an area of active preclinical and clinical investigation. Positive results with some of the more promising agents should lead to strategies to reverse, attenuate or prevent DKD.
本综述旨在概述近期的临床前和临床研究，这些研究为糖尿病肾病（DKD）的治疗提供了新见解，并概述新型疗法的未来方向。
关于新型降糖药物（如钠-葡萄糖协同转运蛋白2抑制剂）的阳性研究结果可能会改变我们治疗患有DKD或有DKD风险的糖尿病患者的方式。其他具有血流动力学作用的药物（如内皮素拮抗剂和盐皮质激素受体拮抗剂）的2期临床试验取得了阳性结果，这分别促使了更大规模的3期试验来研究阿曲生坦和非奈利酮，以确定这些药物是否真的能延缓终末期肾病的发展。目前许多其他途径正在积极进行临床前研究，有望在未来十年内产生有前景的候选药物用于后续临床试验。
DKD仍然是临床前和临床研究的活跃领域。一些更有前景的药物的阳性结果应能带来逆转、减轻或预防DKD的策略。
