2026-04-13T08:31:39Zhttps://recercat.cat/oai/request

oai:recercat.cat:11351/144222026-04-03T00:56:15Zcom_2072_378070com_2072_378040col_2072_378092

2026-04-03T00:56:15Z urn:hdl:11351/14422 Diabetes Mellitus and Chronic Kidney Disease: The Future Is Being Surpassed Martínez-Castelao, Alberto Gorriz, Jose Luis FERNANDEZ-FERNANDEZ, BEATRIZ Soler, María José Navarro-González, Juan F. Diabetis - Tractament Nefropaties diabètiques - Tractament Insuficiència renal crònica - Tractament Antidiabètics - Ús terapèutic CHEMICALS AND DRUGS::Chemical Actions and Uses::Pharmacologic Actions::Physiological Effects of Drugs::Hypoglycemic Agents Other subheadings::Other subheadings::/therapeutic use DISEASES::Endocrine System Diseases::Diabetes Mellitus::Diabetes Complications::Diabetic Nephropathies Other subheadings::Other subheadings::Other subheadings::/drug therapy DISEASES::Endocrine System Diseases::Diabetes Mellitus DISEASES::Male Urogenital Diseases::Urologic Diseases::Kidney Diseases::Renal Insufficiency::Renal Insufficiency, Chronic COMPUESTOS QUÍMICOS Y DROGAS::acciones y usos químicos::acciones farmacológicas::efectos fisiológicos de los fármacos::hipoglicemiantes Otros calificadores::Otros calificadores::/uso terapéutico ENFERMEDADES::enfermedades del sistema endocrino::diabetes mellitus::complicaciones de la diabetes::nefropatías diabéticas Otros calificadores::Otros calificadores::Otros calificadores::/farmacoterapia ENFERMEDADES::enfermedades del sistema endocrino::diabetes mellitus ENFERMEDADES::enfermedades urogenitales masculinas::enfermedades urológicas::enfermedades renales::insuficiencia renal::insuficiencia renal crónica Chronic kidney disease; Diabetes mellitus; Diabetic kidney disease Malaltia renal crònica; Diabetis mellitus; Malaltia renal diabètica Enfermedad renal crónica; Diabetes mellitus; Enfermedad renal diabética Diabetes mellitus (DM) continues to be a global world health problem. Despite medical advances, both DM and chronic kidney disease (CKD) remain global health issues with high mortality and limited options to prevent end-stage renal failure. Current therapies encompass five classes of drugs: (1) angiotensin-converting-enzyme inhibitors (ACEI) or angiotensin II receptor blockers (AIIRB); (2) sodium-glucose-transporter 2 (SGLT2) inhibitors; (3) glucagon-like peptide-1 receptor agonists (GLP-1 RA); and (4) an antagonist of type 1 endothelin receptor (ET1R) with proven efficacy to reduce albuminuria and proteinuria. (5) The mineralocorticoid receptor antagonist (MRA) finerenone has been tested in RCTs as a kidney protective agent. In our review, we summarize many of the principal trials that have generated evidence in this regard. Many novel agents—many of them proven not only for DM management but also for the treatment of obesity with or without DM or heart failure (HF)—are now in development and may be added to the five classical pillars: other non-steroidal MRA (balcinrenone); aldosterone synthase inhibitors (baxdrostat and vicadrostat); other GLP-1 RA (tirzepatide, survodutide, retatrutide, and cagrilintide); ET1 R antagonists, (zibotentan); and soluble guanylate cyclase activators (avenciguat). These new agents aim to slow disease progression further and reduce cardiovascular risk. Future strategies rely on integrated, patient-centered approaches and personalized therapy to curb renal disease and its related complications. 2026-04-03T00:56:15Z 2026-04-03T00:56:15Z 2026-04-01T12:48:25Z 2026-04-01T12:48:25Z 2025-12 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion https://hdl.handle.net/11351/14422 Journal of Clinical Medicine;14(23) https://doi.org/10.3390/jcm14238326 Attribution 4.0 International http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess MDPI Scientia