Novel Therapies for Kidney Disease in People With Diabetes

source extracted confidence: high 2026-04-09
#animals #diabetes-mellitus-type-2 #diabetic-nephropathies #humans #incretins

Novel Therapies for Kidney Disease in People With Diabetes

Khurana et al., 2022 | J Clin Endocrinol Metab | Systematic Review

Citation

Khurana Nayana, James Steven, ... Ekinci Elif I. Novel Therapies for Kidney Disease in People With Diabetes. J Clin Endocrinol Metab. 2022-Jan-01;107(1):e1-e24. doi:10.1210/clinem/dgab639

Abstract

CONTEXT: The increasing burden of diabetic kidney disease (DKD) has led to the discovery of novel therapies. OBJECTIVE: This review aims to summarize the results of recent clinical trials that test the efficacy of potential therapies for DKD. METHODS: A systematized narrative review was performed utilizing the PubMed, Embase (Ovid), CINAHL, and Cochrane databases (January 2010 to January 2021). The included trials assessed the efficacy of specific medications using renal endpoints in adult participants with type 1 or 2 diabetes. RESULTS: Fifty-three trials were identified. Large, multinational, and high-powered trials investigating sodium-glucose cotransporter 2 (SGLT2) inhibitors demonstrated improved renal outcomes, even in patients with established DKD. Trials examining incretin-related therapies also showed some improvement in renal outcomes. Additionally, mineralocorticoid receptor antagonists exhibited potential with multiple improved renal outcomes in large trials, including those involving participants with established DKD. Atrasentan, baricitinib, ASP8232, PF-04634817, CCX140-B, atorvastatin, fenofibrate, probucol, doxycycline, vitamin D, omega-3 fatty acids, silymarin, turmeric, total glucosides of paeony, and tripterygium wilfordii Hook F extract were all associated with some improved renal endpoints but need further exploration. While bardoxolone methyl was associated with a decrease in albuminuria, high rates of cardiovascular adverse effects curtailed further exploration into this agent. Selonsertib, allopurinol, praliciguat, palosuran, benfotiamine, and diacerein were not associated with improved renal outcomes. CONCLUSION: Trials have yielded promising results in the search for new therapies to manage DKD. SGLT2 inhibitors and incretin-related therapies have demonstrated benefit and were associated with improved cardiovascular outcomes. Mineralocorticoid receptor antagonists are another class of agents with increasing evidence of benefits.

Key Findings

Fifty-three trials were identified. Large, multinational, and high-powered trials investigating sodium-glucose cotransporter 2 (SGLT2) inhibitors demonstrated improved renal outcomes, even in patients with established DKD. Trials examining incretin-related therapies also showed some improvement in renal outcomes. Additionally, mineralocorticoid receptor antagonists exhibited potential with multiple improved renal outcomes in large trials, including those involving participants with established D

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population adult participants
Sample Size See abstract
Age Range See abstract
Condition diabetes

MeSH Terms

  • Animals
  • Diabetes Mellitus, Type 2
  • Diabetic Nephropathies
  • Humans
  • Incretins
  • Prognosis
  • Sodium-Glucose Transporter 2 Inhibitors

Evidence Classification

  • Level: Systematic Review
  • Publication Types: Journal Article, Systematic Review
  • Vertical: milk-thistle

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09