Incretins in the Therapy of Diabetic Kidney Disease

Int J Mol Sci. 2021 Nov 15;22(22):12312. doi: 10.3390/ijms222212312.

Abstract

Diabetic kidney disease is a microvascular complication that occurs in patients with diabetes. It is strongly associated with increased risk of kidney replacement therapy and all-cause mortality. Incretins are peptide hormones derived from the gastrointestinal tract, that besides causing enhancement of insulin secretion after oral glucose intake, participate in many other metabolic processes. Antidiabetic drug classes, such as dipeptidyl peptidase 4 inhibitors and glucagon-like peptide receptor agonists, which way of action is based on incretins facility, not only show glucose-lowering properties but also have nephroprotective functions. The aim of this article is to present the latest information about incretin-based therapy and its influence on diabetic kidney disease appearance and progression, point its potential mechanisms of kidney protection and focus on future therapeutic possibilities bound with these two antidiabetic drug classes.

Keywords: diabetes; diabetic kidney disease; incretins; therapy.

Publication types

  • Review

MeSH terms

  • Blood Glucose / metabolism
  • Diabetic Nephropathies / drug therapy*
  • Diabetic Nephropathies / metabolism*
  • Dipeptidyl-Peptidase IV Inhibitors / pharmacology*
  • Dipeptidyl-Peptidase IV Inhibitors / therapeutic use*
  • Gastric Inhibitory Polypeptide / metabolism
  • Glucagon-Like Peptide 1 / metabolism
  • Glucagon-Like Peptide Receptors / agonists*
  • Glucagon-Like Peptide-1 Receptor / agonists*
  • Glucagon-Like Peptide-1 Receptor / metabolism
  • Humans
  • Incretins / metabolism*
  • Insulin / metabolism
  • Insulin Secretion / drug effects
  • Insulin-Secreting Cells / metabolism
  • Protective Agents / pharmacology*
  • Protective Agents / therapeutic use*
  • Signal Transduction / drug effects*

Substances

  • Blood Glucose
  • Dipeptidyl-Peptidase IV Inhibitors
  • GLP1R protein, human
  • Glucagon-Like Peptide Receptors
  • Glucagon-Like Peptide-1 Receptor
  • Incretins
  • Insulin
  • Protective Agents
  • Gastric Inhibitory Polypeptide
  • Glucagon-Like Peptide 1