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DIABETIC KIDNEY DISEASE IN 2018

A promising outlook for diabetic kidney disease

Nature Reviews Nephrology volume 15, pages 68–70 (2019)Cite this article

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In 2018, consolidating evidence for renoprotective benefits was seen with respect to sodium–glucose cotransporter 2 inhibitors and glucagon-like peptide 1 agonists, which are currently being incorporated into clinical practice. The focus now turns to novel therapeutic targets to optimize renoprotection as diabetic kidney disease grows to epidemic proportions worldwide.

Key advances

  • The CANVAS Program reported renal benefits of canagliflozin1; these findings build on evidence from the EMPA-REG OUTCOME trial7 for a renoprotective effect of sodium–glucose cotransporter 2 (SGLT2) inhibitors.

  • The AWARD-7 trial reported renal benefits of dulaglutide2; these results add weight to previous findings of renoprotective effects of glucagon-like peptide 1 (GLP1) agonists.

  • Targeting podocyte histone modification via promotion of H3K27me3 prevented glomerular cell dedifferentiation and loss of renal function in a mouse model of obesity and type 2 diabetes mellitus3.

  • Inhibition of apoptosis signal-regulating kinase 1 (ASK1) prevented oxidative stress and fibrosis and was renoprotective in a mouse model; human trials of ASK1 inhibition in diabetic kidney disease are underway4.

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Fig. 1: Diabetic kidney disease in 2018: current therapies and novel targets.

References

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Authors and Affiliations

  1. Department of Diabetes, Monash University Central Clinical School, Melbourne, Victoria, Australia

    Mark Cooper

  2. Department of Endocrinology and Diabetes, The Alfred Hospital, Melbourne, Victoria, Australia

    Mark Cooper & Annabelle M. Warren

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  1. Mark Cooper
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  2. Annabelle M. Warren
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Correspondence to Mark Cooper.

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Cooper, M., Warren, A. A promising outlook for diabetic kidney disease. Nat Rev Nephrol 15, 68–70 (2019). https://doi.org/10.1038/s41581-018-0092-5

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