Recent progress and future directions in managing diabetic kidney disease

Combining four agents may significantly slow the progression of diabetic kidney disease (DKD).

• SGLT2 inhibitors, GLP-1 receptor agonists, and nonsteroidal mineralocorticoid receptor antagonists have proven cardiorenal benefits in DKD.
• Using combinations of SGLT2 inhibitors, nonsteroidal mineralocorticoid receptor antagonists, and RAAS blockade is associated with a greater reduction in DKD progression than single agents.
• A four-pillar approach, incorporating GLP-1 receptor agonists, SGLT2 inhibitors, nonsteroidal mineralocorticoid receptor antagonists, and RAAS blockade, may provide additional benefits.
• Investigational agents like endothelin receptor antagonists and Janus kinase inhibitors show promise in early Phase 2 trials for DKD treatment.

Simplified