Providence Medical Research Center, Providence Health Care, Spokane, Washington.
Department of Medicine, Nephrology Division, University of Washington , Spokane, Washington.
Am J Physiol Renal Physiol. 2018 Dec 1;315(6):F1519-F1525. doi: 10.1152/ajprenal.00211.2018. Epub 2018 Aug 15.
Diabetic kidney disease (DKD), one of the most common and severe microvascular complications of diabetes, is the leading cause of chronic kidney disease and end-stage kidney disease worldwide. Since the development of renin-angiotensin system inhibition nearly three decades ago, no new therapeutic agents have received regulatory approval for treatment of DKD. Glucagon-like peptide-1 (GLP-1) receptor agonists, a class of newer antihyperglycemic agents, have shown promise for prevention of DKD onset and progression. This perspective summarizes clinical and experimental observations to give insight into biological mechanisms beyond glycemic control, such as natriuresis and anti-inflammatory actions, for preservation of kidney function in patients with diabetes.
糖尿病肾病（DKD）是糖尿病最常见和最严重的微血管并发症之一，也是全球慢性肾脏病和终末期肾病的主要病因。近三十年前肾素-血管紧张素系统抑制药物问世以来，尚无新的治疗药物获得 DKD 治疗的监管批准。胰高血糖素样肽-1（GLP-1）受体激动剂是一类较新的抗高血糖药物，它们在预防 DKD 发病和进展方面显示出了前景。本观点总结了临床和实验观察结果，深入了解了除血糖控制以外的生物学机制，如利钠作用和抗炎作用，以保护糖尿病患者的肾脏功能。
