PMID- 36051422
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220907
IS  - 1948-9358 (Print)
IS  - 1948-9358 (Electronic)
IS  - 1948-9358 (Linking)
VI  - 13
IP  - 7
DP  - 2022 Jul 15
TI  - Renin-angiotensin system blockers-SGLT2 inhibitors-mineralocorticoid receptor 
      antagonists in diabetic kidney disease: A tale of the past two decades!
PG  - 471-481
LID - 10.4239/wjd.v13.i7.471 [doi]
AB  - Several pharmacological agents to prevent the progression of diabetic kidney 
      disease (DKD) have been tested in patients with type 2 diabetes mellitus (T2DM) 
      in the past two decades. With the exception of renin-angiotensin system blockers 
      that have shown a significant reduction in the progression of DKD in 2001, no 
      other pharmacological agent tested in the past two decades have shown any 
      clinically meaningful result. Recently, the sodium-glucose cotransporter-2 
      inhibitor (SGLT-2i), canagliflozin, has shown a significant reduction in the 
      composite of hard renal and cardiovascular (CV) endpoints including progression 
      of end-stage kidney disease in patients with DKD with T2DM at the top of 
      renin-angiotensin system blocker use. Another SGLT-2i, dapagliflozin, has also 
      shown a significant reduction in the composite of renal and CV endpoints 
      including death in patients with chronic kidney disease (CKD), regardless of T2DM 
      status. Similar positive findings on renal outcomes were recently reported as a 
      top-line result of the empagliflozin trial in patients with CKD regardless of 
      T2DM. However, the full results of this trial have not yet been published. While 
      the use of older steroidal mineralocorticoid receptor antagonists (MRAs) such as 
      spironolactone in DKD is associated with a significant reduction in albuminuria 
      outcomes, a novel non-steroidal MRA finerenone has additionally shown a 
      significant reduction in the composite of hard renal and CV endpoints in patients 
      with DKD and T2DM, with reasonably acceptable side effects.
CI  - (c)The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights 
      reserved.
FAU - Singh, Awadhesh Kumar
AU  - Singh AK
AD  - Department of Diabetes & Endocrinology, G.D Hospital & Diabetes Institute, 
      Kolkata 700013, West Bengal, India. draksingh_2001@yahoo.com.
FAU - Singh, Ritu
AU  - Singh R
AD  - Department of Diabetes & Endocrinology, G.D Hospital & Diabetes Institute, 
      Kolkata 700013, West Bengal, India.
LA  - eng
PT  - Editorial
PL  - United States
TA  - World J Diabetes
JT  - World journal of diabetes
JID - 101547524
PMC - PMC9329844
OTO - NOTNLM
OT  - Cardiovascular outcomes
OT  - Chronic kidney disease
OT  - Diabetic kidney disease
OT  - Mineralocorticoid receptor antagonist
OT  - Renal outcomes
OT  - Renin-angiotensin system blockers
OT  - SGLT-2 inhibitors
COIS- Conflict-of-interest statement: The authors have no conflicts of interest to 
      declare.
EDAT- 2022/09/03 06:00
MHDA- 2022/09/03 06:01
PMCR- 2022/07/15
CRDT- 2022/09/02 02:31
PHST- 2022/03/11 00:00 [received]
PHST- 2022/04/19 00:00 [revised]
PHST- 2022/06/18 00:00 [accepted]
PHST- 2022/09/02 02:31 [entrez]
PHST- 2022/09/03 06:00 [pubmed]
PHST- 2022/09/03 06:01 [medline]
PHST- 2022/07/15 00:00 [pmc-release]
AID - 10.4239/wjd.v13.i7.471 [doi]
PST - ppublish
SO  - World J Diabetes. 2022 Jul 15;13(7):471-481. doi: 10.4239/wjd.v13.i7.471.