A New Era in Diabetic Kidney Disease Treatment: The Four Pillars and Strategies to Build Beyond.

Q3 Medicine Electrolyte and Blood Pressure Pub Date : 2024-12-01 Epub Date: 2024-12-30 DOI:10.5049/EBP.2024.22.2.21
Sangyub Han, Sejoong Kim
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Abstract

Diabetic kidney disease (DKD) is a prevalent and complex disease among patients with diabetes in Korea, requiring comprehensive treatment strategies. Traditional management strategies targeting blood pressure, blood sugar, lipid, and lifestyles are foundational approaches of DKD treatment, each of them still holding importance in current paradigms. The four pillars, renin-angiotensin system(RAS) inhibitors, sodium-glucose cotransporter-2 (SGLT2) inhibitors, glucagon-like peptide-1 (GLP-1) receptor agonists, and non-steroidal mineralocorticoid receptor antagonists (nsMRA) can enhance DKD treatment. Expanding beyond these pillars with future-oriented pillars including precision medicine, digital health, gut health, anti-inflammatory/fibrotic agents, psychosocial/behavioral health, and regenerative medicine can further advance DKD treatment strategies, offering a more cohesive framework which shifts a disease-centered approach to a patient-centered approach.

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糖尿病肾病治疗的新时代:四大支柱和今后的发展策略。
糖尿病肾病(DKD)是韩国糖尿病患者中普遍且复杂的疾病,需要综合治疗策略。针对血压、血糖、血脂和生活方式的传统管理策略是DKD治疗的基本方法,它们中的每一个在当前的范例中仍然占有重要地位。肾素-血管紧张素系统(RAS)抑制剂、钠-葡萄糖共转运体-2 (SGLT2)抑制剂、胰高血糖素样肽-1 (GLP-1)受体激动剂和非甾体矿皮质激素受体拮抗剂(nsMRA)这四大支柱可增强DKD治疗。在这些支柱之外扩展面向未来的支柱,包括精准医学、数字健康、肠道健康、抗炎/纤维化药物、社会心理/行为健康和再生医学,可以进一步推进DKD治疗策略,提供一个更有凝聚力的框架,将以疾病为中心的方法转变为以患者为中心的方法。
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来源期刊
Electrolyte and Blood Pressure
Electrolyte and Blood Pressure Medicine-Internal Medicine
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