Chronische Niereninsuffizienz bei Typ-2-Diabetes – die stille Bedrohung einer Multisystemerkrankung

Zusammenfassung

Die hohe Prävalenz von Typ-2-Diabetes (T2D) und die damit einhergehenden Auswirkungen auf verschiedene Organsysteme stellen in der Behandlung der betroffenen Patienten eine große Herausforderung dar. Eine der häufigsten Komplikationen ist die diabetische Nephropathie, die weltweit etwa 700 Millionen Menschen betrifft. Sie ist die Hauptursache für die Entwicklung einer chronischen Niereninsuffizienz (CNI) und führt zu einem signifikant erhöhten kardiovaskulären Risiko. Die diabetische Nephropathie präsentiert sich somit als Multisystemerkrankung und erfordert einen umfassenden Behandlungsansatz. Dieser Ansatz umfasst neben der Optimierung des Lebensstils auch die medikamentöse Therapie einschließlich antihyperglykämischer, antihypertensiver und lipidsenkender Wirkstoffe sowie neuere Wirkstoffe wie SGLT2-Inhibitoren, nicht steroidale Mineralokortikoid-Rezeptorantagonisten und GLP-1-Rezeptoragonisten zur Nephro- und Kardioprotektion.

Abstract

The high prevalence of type 2 diabetes and its associated effects on various organ systems are a major challenge in the treatment of these patients. One of the most common complications is diabetic nephropathy, affecting approximately 700 million people worldwide. It is the leading cause of chronic kidney disease and leads also to a significantly increased cardiovascular risk. Diabetic nephropathy thus presents as a multisystem disease and requires a comprehensive treatment approach. This approach includes optimizing lifestyle, as well as pharmacological therapy including antihyperglycemic, antihypertensive, and lipid-lowering agents, as well as newer agents such as SGLT2 inhibitors, non-steroidal mineralocorticoid receptor antagonists and GLP-1 receptor agonists for nephro- and cardioprotection.

Was ist wichtig?

• Frühzeitige Erkennung der chronischen Niereninsuffizienz (CNI) bei Typ-2-Diabetes (T2D) ist entscheidend für das Management und die Prognose.

• Eine ganzheitliche Behandlung der CNI bei T2D beinhaltet die Lebensstilmaßnahmen, das Blutdruck-, Blutzucker- und Lipidmanagement sowie die Hinzunahme nephroprotektiver Substanzen.

• Nephroprotektive Substanzklassen haben zudem ein kardioprotektives Potenzial.

Schlüsselwörter

Finerenon - diabetische Nephropathie - Typ-2-Diabetes - SGLT2-Inhibitoren - GLP-1-RA

Keywords

Finerenone - GLP-1-RA - type 2 diabetes - diabetic nephropathy - SGLT2-inhibitors

Publication History

Received: 03 March 2024

Accepted after revision: 14 May 2024

Article published online:
31 July 2024

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