New hypoglycemic agents and the kidney: what do the major trials tell us?

F1000Res. 2018 Nov 23:7:F1000 Faculty Rev-1844. doi: 10.12688/f1000research.16135.1. eCollection 2018.

Abstract

As the burden of diabetic kidney disease continues to expand, new therapies to preserve renal function or prevent diabetic nephropathy are urgently needed. In the past decade, a number of new hypoglycemic classes have emerged, each with a unique profile of action and benefits. Here we review the impact of glycemic control on renal outcomes and the results of the major clinical trials of glucagon-like peptide 1 (GLP-1) agonists, dipeptidyl peptidase-4 (DPP-4) inhibitors, and sodium-glucose co-transporter 2 (SGLT2) inhibitors. Both GLP-1 agonists and SGLT2 inhibitors consistently demonstrate renal benefits. Further studies of these new agents in different patient groups and in comparison to (or in combination with) other treatments are required to better define their role in combating the burden of diabetic kidney disease.

Keywords: Chronic Kidney Disease; DPP-4; Diabetic nephropathy; GLP-1; SGLT2; alogliptin; canagliflozin; empagliflozin; liraglutide; macroalbuminuria; saxagliptin; semaglutide.

Publication types

  • Review

MeSH terms

  • Animals
  • Diabetic Nephropathies / drug therapy*
  • Diabetic Nephropathies / prevention & control
  • Glucagon-Like Peptide 1 / agonists
  • Glucagon-Like Peptide 1 / therapeutic use
  • Humans
  • Hypoglycemic Agents / therapeutic use*
  • Renal Insufficiency, Chronic / complications
  • Renal Insufficiency, Chronic / drug therapy
  • Sodium-Glucose Transporter 2 Inhibitors / therapeutic use

Substances

  • Hypoglycemic Agents
  • Sodium-Glucose Transporter 2 Inhibitors
  • Glucagon-Like Peptide 1

Grants and funding

The author(s) declared that no grants were involved in supporting this work.