diaendoСахарный диабетDiabetes mellitus2072-03512072-0378Endocrinology research centre10.14341/DM9845diaendo-9845Research ArticleОбзорыReviewРоль препаратов инкретинового ряда в лечении диабетической болезни почекRole of incretin based therapies in the treatment of diabetic kidney diseasehttps://orcid.org/0000-0003-3445-0387FiorettoPaola

MD, PhD, Department of Medicine

paola.fioretto@unipd.itFrascatiAndrea

MD, Department of Medicine

andrea.frascati@unipd.it<p>University of Padova</p>Italy201817122018215395398Copyright &#x00A9; Fioretto P., Frascati A., 20182018Fioretto P., Frascati A.Fioretto P., Frascati A.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/9845

Диабетическая болезнь почек (ДБП) – серьезное микрососудистое осложнение сахарного диабета (СД), также являющееся основной причиной терминальной стадии почечной недостаточности и ассоциированное с повышенным риском сердечно-сосудистых заболеваний и смертности. Несмотря на достижения в поддержании оптимальных показателей гликемии и артериального давления, приблизительно у 20–40% пациентов с СД развивается ДБП. Тщательный контроль гликемии и АД замедляет снижение расчетной скорости клубочковой фильтрации и альбуминурии, что позволяет отсрочить дебют и развитие диабетической нефропатии. Препараты инкретинового ряда, такие как агонисты рецептора глюкагоноподобного пептида-1 (ГПП-1) и ингибиторы дипептидилпептидазы-4 (ДПП-4), широко используются в качестве сахароснижающей терапии и демонстрируют улучшение почечных исходов при ДБП. В данном обзоре обсуждаются негликемические свойства препаратов инкретинового ряда и их нефропротективное действие на компоненты метаболического синдрома: ожирение, артериальную гипертензию и дислипидемию; уменьшение оксидативного стресса и воспаление; увеличение натрийуреза.

Diabetic kidney disease (DKD), a serious microvascular complication of diabetes mellitus is a leading cause of end-stage renal disease and is associated with an increased risk of cardiovascular morbidity and mortality. Despite advancements in blood glucose and blood pressure (BP) control, ~20% to 40% of patients with diabetes mellitus develop DKD. Intensive glycaemic and BP control positively influence decline in estimated glomerular filtration rate and albuminuria, thereby delaying the onset and progression of diabetic nephropathy. Incretin based therapies namely glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and dipeptidyl peptidase-4 (DPP-4) inhibitors are widely used glucose lowering agents and have shown favorable renal outcomes in DKD. This article discusses the extra-glycaemic properties of incretin based therapies and their renoprotective effects on components of the metabolic syndrome, including obesity, hypertension and dyslipidaemia; reduction in oxidative stress and inflammation; and increase in natriuresis.

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