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2型糖尿病急性肾疾病的管理: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抑制剂的潜在作用

Management of acute kidney disease in type 2 diabetes: the potential role of GLP-1 RAs and SGLT2-Is.

作者信息

Giugliano Dario, Esposito Katherine, De Nicola Luca

机构信息

Endocrine and Metabolic Unit, Department of Advanced Medical and Surgical Sciences, Università della Campania Luigi Vanvitelli, Naples, Italy.

Nephrology Unit, Department of Advanced Medical and Surgical Sciences, Università della Campania Luigi Vanvitelli, Piazza L. Miraglia 2, 80138, Naples, Italy.

出版信息

J Nephrol. 2024 Nov;37(8):2347-2350. doi: 10.1007/s40620-024-02107-2. Epub 2024 Oct 2.

Abstract

Acute kidney disease (AKD) is defined as subacute damage and/or loss of kidney function occurring 7 to 90 days after acute kidney injury (AKI), and bearing a high risk of progression to chronic kidney disease. Current management of AKD is non-specific and includes prevention of repeated AKI, early and regular follow-up by a nephrologist, resumption and dose adjustment of statins and renin-angiotensin system inhibitors, optimization of blood pressure control, nutrition management, and nephrotoxin avoidance. Recently, SGLT2i and GLP1- RAs have emerged as potential therapeutic tools preventing the transition from acute to chronic kidney disease due to their efficacy in preserving renal function.

摘要

急性肾脏病(AKD)的定义为急性肾损伤(AKI)后7至90天出现的亚急性肾功能损害和/或丧失,且进展为慢性肾脏病的风险很高。目前AKD的管理缺乏特异性,包括预防AKI复发、由肾病专家进行早期和定期随访、他汀类药物和肾素-血管紧张素系统抑制剂的恢复使用及剂量调整、优化血压控制、营养管理以及避免肾毒性。最近,钠-葡萄糖协同转运蛋白2抑制剂(SGLT2i)和胰高血糖素样肽-1受体激动剂(GLP1-RAs)已成为预防急性肾损伤向慢性肾脏病转变的潜在治疗手段,因为它们在保护肾功能方面具有疗效。

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