Advances in the management of diabetic kidney disease: beyond sodium-glucose co-transporter 2 inhibitors

Abstract

Progress in the treatment of diabetic kidney disease (DKD) has been modest since the early trials on renin-angiotensin-aldosterone system inhibitors (RAASis). Although sodium-glucose co-transporter 2 inhibitors (SGLT2is) have revolutionized the management of DKD by lowering proteinuria and protecting organs, other novel treatment approaches with good evidence and efficacy that can be used in conjunction with a RAASi or SGLT2i in managing DKD have emerged in the past few years. This review discusses the evidence for glucagon-like peptide-1 receptor agonist, selective mineralocorticoid receptor antagonist, and selective endothelin A receptor antagonist, emerging treatment options for DKD beyond SGLT2 inhibition.

Keywords

• diabetic kidney disease
• diabetic nephropathies
• glucagon-like peptide-1 receptor agonist
• non-steroidal mineralocorticoid receptor antagonist
• selective endothelin receptor antagonist
• sodium-glucose transporter 2 inhibitors