Department of Nephrology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
Int J Mol Sci. 2022 Sep 17;23(18):10882. doi: 10.3390/ijms231810882.
Diabetic kidney disease (DKD) is one of the most common causes of end-stage renal disease worldwide. The treatment of DKD is strongly associated with clinical outcomes in patients with diabetes mellitus. Traditional therapeutic strategies focus on the control of major risk factors, such as blood glucose, blood lipids, and blood pressure. Renin-angiotensin-aldosterone system inhibitors have been the main therapeutic measures in the past, but the emergence of sodium-glucose cotransporter 2 inhibitors, incretin mimetics, and endothelin-1 receptor antagonists has provided more options for the management of DKD. Simultaneously, with advances in research on the pathogenesis of DKD, some new therapies targeting renal inflammation, fibrosis, and oxidative stress have gradually entered clinical application. In addition, some recently discovered therapeutic targets and signaling pathways, mainly in preclinical and early clinical trial stages, are expected to provide benefits for patients with DKD in the future. This review summarizes the traditional treatments and emerging management options for DKD, demonstrating recent advances in the therapeutic strategies for DKD.
糖尿病肾病(DKD)是全球范围内导致终末期肾病的最常见病因之一。糖尿病患者的临床结局与 DKD 的治疗密切相关。传统的治疗策略侧重于控制主要危险因素,如血糖、血脂和血压。过去,肾素-血管紧张素-醛固酮系统抑制剂一直是主要的治疗措施,但钠-葡萄糖共转运蛋白 2 抑制剂、肠促胰岛素类似物和内皮素-1 受体拮抗剂的出现为 DKD 的治疗提供了更多选择。同时,随着对 DKD 发病机制的研究进展,一些针对肾脏炎症、纤维化和氧化应激的新型治疗方法逐渐进入临床应用。此外,一些最近发现的治疗靶点和信号通路,主要处于临床前和早期临床试验阶段,有望为 DKD 患者带来获益。本文综述了 DKD 的传统治疗方法和新兴的治疗选择,展示了 DKD 治疗策略的最新进展。