Infectology

Hypertension and nephrology

APRIL 28, 2023

[For kidney protection and beyond. New possibilities of renoprotection]

BALOGH Dóra Bianka, FEKETE Andrea, REUSZ György

[As a result of intensive basic research and clinical trials of the last decade, drugs with a new mechanism of action of renoprotection have entered clinical practice. Following the drugs that act by inhibiting the renin-angiotensin system, which are already considered the "gold standard", the new drugs originally designed and introduced for the treatment of diabetes mellitus have expanded our therapeutic armamentarium, such as glucagon-like peptide-1 receptor agonists (GLP-1RA), with evidence of reducing macroalbuminuria and serum creatinine in diabetic nephropathy and sodium glucose cotransporter-2 (SGLT-2) inhibitors, showing evidence of nephroprotection in patients with diabetic nephropathy as well as in CKD with non-diabetic etiology. Well-designed clinical trials have also confirmed the cardiovascular protective effect of these drugs, and in this context, a number of proven and potential mechanisms have been described that may play a role in the effects described above. The observation that the nephroprotection originally proven in diabetes is also valid for SGLT-2 inhibitors in non-diabetic chronic kidney patients is particularly promising, providing a new therapeutic tool to slow down the progression of chronic kidney disease. In the future, the mechanism of action of these drugs needs to be further clarified. The final goal is to verify their effectiveness in large population based studies including patients from the "everyday life".]

HUN 2023;27(02)