Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2018 Jan;8(1):8-17.
doi: 10.1016/j.kisu.2017.10.004. Epub 2017 Dec 29.

Cardiovascular outcomes in diabetic kidney disease: insights from recent clinical trials

Natalia A Rocha  1 , Peter A McCullough  2   3   4
Affiliations
Review

Cardiovascular outcomes in diabetic kidney disease: insights from recent clinical trials

Natalia A Rocha et al. Kidney Int Suppl (2011). 2018 Jan.

Abstract

The prevalence of type 2 diabetes is catalyzing a pandemic in kidney disease, with ensuing cardiovascular complications. The effort to identify antidiabetic agents capable of promoting benefits that go beyond the bounds of glucose control has produced remarkable outcomes in recent cardiovascular outcomes trials in patients with type 2 diabetes mellitus, many of whom have diabetic kidney disease. Two novel antidiabetic drug classes, sodium-glucose cotransporter 2 inhibitors (SGLT2is) and glucagon-like peptide-1 receptor agonists (GLP-1 RAs), improve cardiovascular outcomes in different ways, with SGLT2is reducing the risk of heart failure and cardiovascular death and GLP-1 RAs being associated with reduced risk of myocardial infarction and cardiovascular death. Further mechanistic studies and additional cardiovascular outcome trials are ongoing and are expected to determine whether these benefits are a result of class effect, as well as to delineate optimum timing for intervention and population target.

Keywords: GLP-1 receptor agonist; SGLT2 inhibitor; cardiovascular risk; diabetic kidney disease.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Mechanisms postulatedfor cardiovascular and renal effects of sodium–glucose cotransporter 2 inhibitors. LV, left ventricular.
Figure 2
Figure 2
Mechanisms postulated for cardiovascular and renal effects of glucagon-like peptide-1 receptor agonists. GLP-1, glucagon-like peptide-1.
See this image and copyright information in PMC

References

    1. Whiting D.R., Guariguata L., Weil C. IDF diabetes atlas: global estimates of the prevalence of diabetes for 2011 and 2030. Diabetes Res Clin Pract. 2011;94:311–321. - PubMed
    1. Afkarian M., Sachs M.C., Kestenbaum B. Kidney disease and increased mortality risk in type 2 diabetes. J Am Soc Nephrol. 2013;24:302–308. - PMC - PubMed
    1. Afkarian M., Katz R., Bansal N. Diabetes, kidney disease, and cardiovascular outcomes in the Jackson heart study. Clin J Am Soc Nephrol. 2016;11:1384–1391. - PMC - PubMed
    1. Chew D.P., Lincoff A.M., Gurm H. Bivalirudin versus heparin and glycoprotein IIb/IIIa inhibition among patients with renal impairment undergoing percutaneous coronary intervention (a subanalysis of the REPLACE-2 trial) Am J Cardiol. 2005;95:581–585. - PubMed
    1. Nikolsky E., Mehran R., Turcot D. Impact of chronic kidney disease on prognosis of patients with diabetes mellitus treated with percutaneous coronary intervention. Am J Cardiol. 2004;94:300–305. - PubMed

LinkOut - more resources