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Review
. 2023 May 10;12(10):3377.
doi: 10.3390/jcm12103377.

Nephroprotective Properties of Antidiabetic Drugs

Christian Gerdes  1 , Nicolle Müller  1 , Gunter Wolf  1 , Martin Busch  1
Affiliations
Review

Nephroprotective Properties of Antidiabetic Drugs

Christian Gerdes et al. J Clin Med. .

Abstract

Chronic kidney disease (CKD) is associated with increased morbidity and mortality, especially from cardiovascular (CV) causes, and especially in people with diabetes mellitus (DM). Already the presence of DM increases CV risk and potentiates the risk of CKD. Therefore, besides glycemic control, prevention and treatment of CKD to slow its progression are of clinical importance. A significant nephroprotective effect of novel antidiabetic drugs, namely sodium-glucose cotransporter 2 inhibitors (SGLT2-I) and glucagon-like peptide 1 receptor agonists (GLP1-RA), has been shown on top of their glucose-lowering effects and was confirmed in cardiovascular outcome trials. GLP1-RA mainly reduced the risk of macroalbuminuria, whereas SGLT2-I were also associated with a lower risk of declining glomerular filtration rate (GFR) over time. The nephroprotective effects of SGLT2-I are also evident in people without DM. According to current guidelines, SGLT2-I and/or GLP1-RA are recommended for people with DM who have chronic kidney disease and/or increased cardiovascular risk. However, other antidiabetic drugs offer nephroprotective properties, which will also be discussed in this review.

Keywords: GLP1 receptor agonists; SGLT2 inhibitors; albuminuria; antidiabetic drugs; chronic kidney disease; diabetes mellitus; eGFR; nephroprotection; treatment.

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Conflict of interest statement

The authors declare no conflict of interest, except for Martin Busch, who received speaker honoraria from Astra and Boehringer Ingelheim as well as honoraria for providing advice to Boehringer Ingelheim.

Figures

Figure 1
Figure 1
Nephroprotective mechanism of SGLT-2-inhibitors.
See this image and copyright information in PMC

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