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首页> 外文期刊>Journal of diabetes. >Review of glucagon‐like peptide‐1 receptor agonists for the treatment of type 2 diabetes mellitus in patients with chronic kidney disease and their renal effects
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Review of glucagon‐like peptide‐1 receptor agonists for the treatment of type 2 diabetes mellitus in patients with chronic kidney disease and their renal effects

机译：对胰高糖素的类肽1受体受体激动剂治疗2型糖尿病糖尿病患者的慢性肾脏疾病和肾的影响

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Abstract Type 2 diabetes mellitus (T2DM) is the most common cause of chronic kidney disease (CKD), and when it causes CKD it is collectively referred to as diabetic kidney disease. One of the newer therapies for managing hyperglycemia is the glucagon‐like peptide‐1 receptor agonist (GLP‐1RA) drug class. This review summarizes the effects of GLP‐1RAs in patients with T2DM with CKD and evidence for renoprotection with GLP‐1RAs using data from observational studies, prospective clinical trials, post hoc analyses, and meta‐analyses. Evidence from some preclinical studies was also reviewed. Taken together, subgroup analyses of patients with varying degrees of renal function demonstrated that glycemic control with GLP‐1RAs was not markedly less effective in patients with mild or moderate renal impairment vs that in patients with normal function. GLP‐1RAs were associated with improvements in some cardiorenal risk factors, including systolic blood pressure and body weight. Furthermore, several large cardiovascular outcome studies showed reduced risks of composite renal outcomes, mostly driven by a reduction in macroalbuminuria, suggesting potential renoprotective effects of GLP‐1RAs. In conclusion, GLP‐1RAs effectively reduced hyperglycemia in patients with mild or moderately impaired kidney function in the limited number of studies to date. GLP‐1RAs may be considered in combination with other glucose‐lowering medications because of their ability to lower glucose in a glucose‐dependent manner, lowering their risk for hypoglycemia, while improving some cardiorenal risk factors. Potential renoprotective effects of GLP‐1RAs, and their renal mechanisms of action, warrant further investigation.
机译：抽象的2型糖尿病(T2DM)病人体内慢性肾脏疾病的最常见原因(CKD),当它导致CKD集体被称为糖尿病肾病。管理高血糖症的新疗法胰高糖素的类肽1受体激动剂(地理GLP 1 ra)类药物。GLP 1 ras的患者与2型糖尿病的影响CKD和证据为renoprotection GLP 1 ras使用数据从观察性研究,前瞻性临床试验,事后分析,和meta分析。研究也回顾了。子群分析患者的不同程度的肾功能证明血糖控制与GLP 1 ras并不明显在轻度或中度患者更有效患者的肾功能损害vs,正常函数。改善一些cardiorenal风险因素,包括收缩压和身体重量。结果研究表明降低组合的风险肾的结果,主要由减少macroalbuminuria,暗示潜在renoprotective GLP 1 ras应承担的的影响。结论,GLP 1 ras有效减少轻度或中度患者的高血糖在有限数量的肾功能受损迄今为止的研究。结合其他葡萄糖量降低药物治疗,因为他们的能力低葡萄糖在葡萄糖高依赖的方式在降低低血糖的风险,同时提高一些cardiorenal风险因素。renoprotective GLP 1应承担的ras的影响,他们的肾的作用机理,进一步保证调查。

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