diaendoСахарный диабетDiabetes mellitus2072-03512072-0378Endocrinology research centre10.14341/DM12379diaendo-12379Research ArticleОбзорыReviewНефропротективный потенциал агонистов рецепторов глюкагоноподобного пептида 1Nephroprotective potential of glucagon-like peptide-1 receptor agonistshttps://orcid.org/0000-0002-3433-0142ШамхаловаМинара ШамхаловнаShamkhalovaMinara S.

д.м.н.

MD, PhD

shamkhalova@mail.ruhttps://orcid.org/0000-0002-7768-4717СкляникИгорь АлександровичSklyanikIgor A.

аспирант

MD, PhD student

sklyanik.igor@gmail.comhttps://orcid.org/0000-0003-3893-9972ШестаковаМарина ВладимировнаShestakovaMarina V.

д.м.н., профессор, академик РАН

MD, PhD, Professor

nephro@endocrincentr.ruНациональный медицинский исследовательский центр эндокринологииРоссияEndocrinology Research CentreRussian Federation2020210420202315664Copyright © Шамхалова М.Ш., Скляник И.А., Шестакова М.В., 20202020Шамхалова М.Ш., Скляник И.А., Шестакова М.В.Shamkhalova M.S., Sklyanik I.A., Shestakova M.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.dia-endojournals.ru/jour/article/view/12379

Сахарный диабет (СД), как ведущая причина заболевания почек, все больше конкурирует за ограниченные ресурсы здравоохранения. Диабетическая болезнь почек (ДБП) остается значимой причиной терминальной почечной недостаточности во многих странах и ассоциирована с высоким риском кардиоваскулярной патологии и смертности. Предметом особого обсуждения в последние годы стало разнообразие клинических фенотипов ДБП у пациентов с СД 2 типа, обусловленное разнообразием патогенетических факторов, особенностью эволюции осложнения под влиянием современных методов терапии. Оптимальное управление уровнями гликемии и гипертонии, своевременная блокада ренин-ангиотензин-альдостероновой системы не обеспечивают достаточную ренопротекцию. В последнее десятилетие активно обсуждается нефропротективный потенциал группы современных сахароснижающих препаратов – агонистов рецепторов глюкагоноподобного пептида 1 (АР-ГПП1), зарекомендовавших себя как достаточно эффективно контролирующие гликемию, компоненты метаболического синдрома (вес, систолическое АД, липидный спектр), а также значимо снижающих риск первичной 3-компонентной конечной точки (МАСЕ) (кардиоваскулярная смерть, нефатальный инфаркт миокарда, нефатальный инсульт) по данным крупных исследований сердечно-сосудистой безопасности. Ренальные эффекты АР-ГПП1 обусловлены широким спектром прямого и непрямого влияния ГПП1 на почечные структуры и функции благодаря их противовоспалительным, антиоксидантным, антиапоптотическим свойствам.

Patients with diabetes mellitus (DM), which is a key factor in the development of kidney diseases, are increasingly competing for limited healthcare resources. Diabetic kidney disease (DKD) remains a significant cause of end-stage renal failure in the patients of many countries and is also associated with a high risk of cardiovascular pathology and mortality. The variety of clinical phenotypes of DKD in patients with type 2 diabetes mellitus (DM2) occurring due to a variety of pathogenetic factors and the characteristics of the evolution of complications under the influence of contemporary therapeutic methods, has been a special subject of discussion in recent years. Optimal control of the level of glycaemia and hypertension and timely blockade of the renin–angiotensin–aldosterone system do not provide sufficient protection for the kidneys. Over the recent decade, the nephroprotective potential of a group of modern anti-hyperglycaemic agents, i.e., glucagon-like peptide 1 receptor agonists (GLP1 RA) has been actively discussed. GLP1 RA have proven to be quite effective in controlling glycaemia and metabolic syndrome components (weight, systolic blood pressure and lipid profile) and in significantly reducing the risk of the primary, three-component endpoint (major adverse cardiac events: cardiovascular death, nonfatal myocardial infarction and nonfatal stroke) according to large studies on cardiovascular safety. The renal effects of GLP1 RA are attributed to a wide range of direct and indirect effects of glucagon-like peptide-1 on renal structures and functions owing to their anti-inflammatory, anti-oxidant and anti-apoptotic properties.

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The authors declare that there are no conflicts of interest present.