Contemporary management of advanced chronic kidney disease: An evidence-based review
Abstract
Chronic kidney disease (CKD) is a major contributor to global morbidity and mortality, traditionally managed through renin-angiotensin system (RAS) inhibition and supportive care. Recent therapeutic advances have transformed this landscape, offering targeted interventions that modify disease progression and improve cardiovascular and renal outcomes. This review summarizes emerging treatments across key domains of CKD management. Sodium-glucose cotransporter 2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists have demonstrated robust cardiorenal benefits, particularly in patients with type 2 diabetes mellitus (T2DM). SGLT2 inhibitors are now widely used in CKD and heart failure, including among non-diabetic populations. GLP-1 receptor agonists are approved for T2DM and cardiovascular risk reduction, with recent expansion to CKD in T2DM. Nonsteroidal mineralocorticoid receptor antagonists (nsMRAs), particularly finerenone, provide additional cardiorenal protection with a lower risk of hyperkalemia than traditional steroidal agents. In autosomal dominant polycystic kidney disease (ADPKD), tolvaptan remains the only approved disease-modifying therapy, with clinical trials and real-world data supporting its efficacy across a range of disease stages. Emerging regenerative strategies, including mesenchymal stem cell (MSC) therapy and xenotransplantation using genetically modified pig kidneys, have shown early promise in preclinical models and limited human…
Read the paper
Related studies
- The Role of AMPK Activation for Cardioprotection in Doxorubicin-Induced Cardiotoxicity
- Hypoglycemic medicines in the treatment of Alzheimer’s disease: Pathophysiological links between AD and glucose metabolism
- Isorhamnetin Reduces Glucose Level, Inflammation, and Oxidative Stress in High-Fat Diet/Streptozotocin Diabetic Mice Model
- Modulating Sirtuin Biology and Nicotinamide Adenine Diphosphate Metabolism in Cardiovascular Disease—From Bench to Bedside
- Characterization of the SGLT2 Interaction Network and Its Regulation by SGLT2 Inhibitors: A Bioinformatic Analysis
- Early Treatment with Empagliflozin and GABA Improves β-Cell Mass and Glucose Tolerance in Streptozotocin-Treated Mice
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.