Renal Evaluation and Protection

Clin Geriatr Med. 2020 Aug;36(3):431-445. doi: 10.1016/j.cger.2020.04.004. Epub 2020 Apr 17.

Abstract

Diabetes and diabetic nephropathy have become more prevalent in the elderly population. Diabetic nephropathy has become increasingly prevalent in the elderly population. The presence of this disease in an age group suffering multiple comorbidities has altered the pathophysiology and leading cause of mortality. Mortality has become linked more often to cardiovascular events rather than progression of end-stage-renal-disease, which explains the recent shift of focus of trials to improving cardiovascular-outcomes in patients with diabetes. In this chapter, we emphasize the difference in treatment modalities and goals of therapy in elderly versus young. In addition, we discuss results from recent outcome trials with regards to renal benefits of sodium-glucose co-transporter-2-inhibitors and glucagon-like peptide-1-receptor-agonists.

Keywords: Albuminuria; Chronic kidney disease; Diabetic nephropathy; Type 2 diabetes.

Publication types

  • Review

MeSH terms

  • Aged
  • Albuminuria
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / prevention & control*
  • Creatinine / blood
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetic Nephropathies / etiology
  • Diabetic Nephropathies / prevention & control*
  • Disease Progression
  • Humans
  • Hypoglycemic Agents / pharmacology*
  • Hypoglycemic Agents / therapeutic use
  • Kidney / drug effects*
  • Renal Insufficiency, Chronic*

Substances

  • Hypoglycemic Agents
  • Creatinine