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IL33/ST2 Axis in Diabetic Kidney Disease: A Literature Review
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GLP-1 Receptor Agonists and Kidney Protection

Unit of Internal Medicine, Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo (FG), Italy
Department of Clinical and Experimental Medicine, University of Messina, 98121 Messina, Italy
Department of Internal Medicine, University of Genoa and Policlinico San Martino-IST, 16131 Genoa, Italy
Author to whom correspondence should be addressed.
Medicina 2019, 55(6), 233;
Received: 21 March 2019 / Revised: 18 April 2019 / Accepted: 30 May 2019 / Published: 31 May 2019
(This article belongs to the Special Issue Carbohydrate and Insulin Metabolism in Chronic Kidney Disease)
Type 2 diabetes mellitus (T2DM) is the leading cause of chronic kidney disease (CKD). Diabetic nephropathy (DN) is determined by specific pathological structural and functional alterations of the kidneys in patients with diabetes, and its clinical manifestations are albuminuria and decline of glomerular filtration rate (GFR). Apart from renin–angiotensin–aldosterone system (RAAS) inhibitors, no other drugs are currently available as therapy for diabetic kidney disease (DKD). Glucagon-like peptide-1 receptor (GLP-1R) agonists are a new class of anti-hyperglycemic drugs which have been demonstrated to prevent the onset of macroalbuminuria and reduce the decline of GFR in diabetic patients. These drugs may exert their beneficial actions on the kidneys through blood glucose- and blood pressure (BP)-lowering effects, reduction of insulin levels and weight loss. Clinical benefits of GLP-1R agonists were acknowledged due to data from large randomized phase III clinical trials conducted to assess their cardiovascular(CV) safety. These drugs improved renal biomarkers in placebo-controlled clinical studies, with effects supposed to be independent of the actions on glycemic control. In this review, we will focus on the actions of GLP-1R agonists on glucose metabolism and kidney physiology, and evaluate direct and indirect mechanisms through which these drugs may confer renal protection. View Full-Text
Keywords: type 2 diabetes mellitus; diabetic kidney disease; albuminuria; glucagon-like peptide-1 receptor agonist; kidney protection type 2 diabetes mellitus; diabetic kidney disease; albuminuria; glucagon-like peptide-1 receptor agonist; kidney protection
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Greco, E.V.; Russo, G.; Giandalia, A.; Viazzi, F.; Pontremoli, R.; De Cosmo, S. GLP-1 Receptor Agonists and Kidney Protection. Medicina 2019, 55, 233.

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