Optimizing Drug Therapy in Kidney Diseases: Effectiveness and Safety

A special issue of Pharmaceutics (ISSN 1999-4923). This special issue belongs to the section "Pharmacokinetics and Pharmacodynamics".

Deadline for manuscript submissions: 30 September 2025 | Viewed by 661

Special Issue Editors


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Guest Editor
1. Department of Medical-Surgery Therapeutics, Pharmacology Section, Faculty of Medical and Health Sciences, University of Extremadura, Av. de Elvas s/n., 06071 Badajoz, Spain
2. Personalized Medicine and Mental Health Unit (MEPER), Extremadura Biosanitary University Research Institute of Extremadura (INUBE), Av. de Elvas s/n., 06080 Badajoz, Spain
Interests: pharmacogenetics; pharmacogenomics; clinical pharmacology; personalized and precision medicine; psychopharmacology; nephropharmacology

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Guest Editor
Department of Clinical Pharmacy and Biopharmacy, Poznan University of Medical Sciences, 60-806 Poznan, Poland
Interests: tacrolimus; drug–drug interactions; pharmacotherapy of kidney diseases; drug-induced nephrotoxicity; pharmacokinetics

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Guest Editor
Department of General and Transplant Surgery, Poznan University of Medical Sciences, 60-355 Poznan, Poland
Interests: glomerulonephritis; kidney transplantation; immunosuppression; hemodialysis; peritoneal dialysis; vasculitis

Special Issue Information

Dear Colleagues,

It is known that diabetes, hypertension, or glomerulonephritis are the cause of chronic kidney disease (CKD), which is classified as a civilization disease. Therefore, research into new drugs for the treatment of kidney diseases is needed. In recent years, biological treatment, including monoclonal antibodies, has been a revolution in nephrology. Chronic kidney disease is associated with disorders of pharmacokinetic processes, mainly at the stage of distribution or excretion of drugs. It is important to appropriately modify the dosage of drugs depending on the filtration function of the kidneys in order to maintain a therapeutic drug concentration and the safety of pharmacotherapy. Patients treated with renal replacement therapy (hemodialysis, peritoneal dialysis) require supplementation of doses to support the effectiveness of treatment. Patients after kidney transplantation take immunosuppressive drugs; polypharmacy increases the risk of drug–drug interactions. One of the tools for optimizing pharmacotherapy is therapeutic drug monitoring, which plays a key role in the group of patients with chronic kidney disease.

We invite researchers studying pharmacokinetics, pharmacodynamics, and drug–drug interactions in patients with kidney diseases to submit original research articles or review articles. The purpose of this Special Issue is to provide both researchers and clinicians with up-to-date information.

Dr. Pedro Dorado
Dr. Miłosz Miedziaszczyk
Dr. Ilona Idasiak-Piechocka
Guest Editors

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Keywords

  • drug–drug interactions
  • pharmacotherapy of kidney diseases
  • immunosuppression
  • drug-induced nephrotoxicity
  • glomerulonephritis
  • kidney transplantation
  • hemodialysis
  • peritoneal dialysis
  • vasculitis

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Published Papers (1 paper)

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Research

12 pages, 1498 KiB  
Article
Long-Term Effect of Semaglutide on the Glomerular Filtration Rate Slope in High-Risk Patients with Diabetic Nephropathy: Analysis in Real-World Clinical Practice
by Enrique Luna, Álvaro Álvarez, Jorge Rodriguez-Sabiñón, Juan Villa, Teresa Giraldo, Maria Victoria Martín, Eva Vázquez, Noemi Fernández, Belén Ruiz, Guadalupe Garcia-Pino, Coral Martínez, Lilia Azevedo, Rosa María Diaz, Nicolas Roberto Robles and Guillermo Gervasini
Pharmaceutics 2025, 17(7), 943; https://doi.org/10.3390/pharmaceutics17070943 - 21 Jul 2025
Viewed by 423
Abstract
Background: Semaglutide, a GLP-1 receptor agonist, has shown promising nephroprotective effects in clinical trials, though real-world data on its long-term impact on renal function in high-risk diabetic nephropathy patients remain scarce. Methods: We conducted a multicenter, retrospective observational study involving 156 patients with [...] Read more.
Background: Semaglutide, a GLP-1 receptor agonist, has shown promising nephroprotective effects in clinical trials, though real-world data on its long-term impact on renal function in high-risk diabetic nephropathy patients remain scarce. Methods: We conducted a multicenter, retrospective observational study involving 156 patients with type 2 diabetes and chronic kidney disease (CKD) treated with subcutaneous semaglutide between 2019 and 2023. Inclusion required an eGFR > 15 mL/min/1.73 m2 or albuminuria > 30 mg/g and at least two years of follow-up. The primary outcome was the change in eGFR slope after semaglutide initiation. Subgroup analyses were performed based on baseline eGFR, albuminuria, and SGLT2i co-treatment. Results: In the whole study population, the median eGFR slope significantly improved from −3.29 (IQR 7.54) to −0.79 (IQR 6.01) mL/min/1.73 m2/year post-treatment (p < 0.001). Multiple linear regression showed a hazard ratio for the effect of semaglutide on the eGFR slope of 4.06 (2.43–5.68), p < 0.001. In patients with baseline eGFR < 60 mL/min/1.73 m2, the slope improved from −3.77 to −1.01 (p < 0.0001), while patients on concurrent SGLT2i therapy saw slope changes from −2.96 to −0.37 (p < 0.0001). Patients with albuminuria 30–1000 mg/g also improved from −2.96 to −0.04 (p < 0.0001); however, those > 1000 mg/g did not show a significant change (p = 0.184). Semaglutide also reduced BMI (p = 0.04), HbA1c (p = 0.002), triglycerides (p = 0.001), CRP (p = 0.003), and GGT values (p = 0.004). Conclusions: In real-world practice, semaglutide significantly attenuated renal function decline in high-risk diabetic patients, particularly those with advanced CKD or concurrent SGLT2i therapy. These findings support its nephroprotective role beyond glycemic control. Full article
(This article belongs to the Special Issue Optimizing Drug Therapy in Kidney Diseases: Effectiveness and Safety)
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