Treatment options for type 2 diabetes mellitus in patients with chronic kidney disease - old and new drugs

• Autor(a) principal: Ferreira,Ana
• Data de Publicação: 2019
• Outros Autores: Bastos,Filipa, Cordeiro,Maria Carlos, Portugal,Jorge
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692019000200006
• topic: type 2 diabetes mellitus; chronic kidney disease; cardiovascular outcomes; renal outcomes

Chronic kidney disease is highly prevalent in patients with diabetes mellitus. There are many specific aspects in the treatment of diabetes that have to be taken into account when there is concomitant nephropathy. All antihyperglycemic drugs can be used in earlier stages of chronic kidney disease. With worsening nephropathy, most will require dose adjustments (some eventually suspension) and increased monitoring of adverse events and kidney function. New treatment options that are safe and effective are now available for more advanced stages of disease. Moreover, findings from large clinical trials suggest that some drugs, namely GLP-1 receptor agonists and SGLT2 inhibitors, might potentially have kidney and cardiovascular protective effects, although clinical significance and putative mechanisms are not yet fully understood. The aim of this review is to provide an updated overview of relevant data to guide clinical practice in the use of antihyperglycemic agents in chronic kidney disease patients, including older drugs and also the most recently available treatment options.