Neumiller Joshua J, Alicic Radica Z, Tuttle Katherine R
Department of Pharmacotherapy, Washington State University College of Pharmacy, Spokane, Washington;
Providence Medical Research Center, Providence Health Care, Spokane, Washington.
J Am Soc Nephrol. 2017 Aug;28(8):2263-2274. doi: 10.1681/ASN.2016121372. Epub 2017 May 2.
Diabetic kidney disease is among the most frequent complications of diabetes, with approximately 50% of patients with ESRD attributed to diabetes in developed countries. Although intensive glycemic management has been shown to delay the onset and progression of increased urinary albumin excretion and reduced GFR in patients with diabetes, conservative dose selection and adjustment of antihyperglycemic medications are necessary to balance glycemic control with safety. A growing body of literature is providing valuable insight into the cardiovascular and renal safety and efficacy of newer antihyperglycemic medications in the dipeptidyl peptidase-4 inhibitor, glucagon-like peptide-1 receptor agonist, and sodium-glucose cotransporter 2 inhibitor classes of medications. Ongoing studies will continue to inform future use of these agents in patients with diabetic kidney disease.
糖尿病肾病是糖尿病最常见的并发症之一，在发达国家，约50%的终末期肾病患者归因于糖尿病。尽管强化血糖管理已被证明可延缓糖尿病患者尿白蛋白排泄增加和肾小球滤过率降低的发生及进展，但选择保守剂量并调整降糖药物对于平衡血糖控制与安全性是必要的。越来越多的文献为二肽基肽酶-4抑制剂、胰高血糖素样肽-1受体激动剂和钠-葡萄糖协同转运蛋白2抑制剂等新型降糖药物的心血管和肾脏安全性及疗效提供了有价值的见解。正在进行的研究将继续为这些药物在糖尿病肾病患者中的未来应用提供依据。
