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Diabetes aktuell 2020; 18(03): 114-118
DOI: 10.1055/a-1152-2093
Schwerpunkt
© Georg Thieme Verlag Stuttgart · New York

Stellenwert der GLP-1-Rezeptoragonisten für die diabetische Niere

Peter Weyrich
1   KfH-Nierenzentrum Unterhaching
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Publication History

Publication Date:
15 May 2020 (online)

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ZUSAMMENFASSUNG

GLP-1-Rezeptoragonisten beeinflussen den Stoffwechsel über zahlreiche Mechanismen und haben einen festen therapeutischen Stellenwert bei der Blutzuckerkontrolle diabetischer Patienten. Der unbestrittene Nutzen der GLP-1-Rezeptoragonisten für kardiovaskuläre Endpunkte lässt vermuten, dass auch die sehr gefäßreiche Niere bei Diabetes von ihnen profitiert. Nach Lektüre dieses Schwerpunktartikels soll der Leser mit der aktuellen Studienlage von GLP-1-Rezeptoragonisten zu renalen Endpunkten vertraut sein. Zudem wird ein Überblick über die Dosierung von GLP-1-Rezeptoragonisten bei chronischer Nierenerkrankung (CKD), Praxistipps zur korrekten Flüssigkeitsbilanzierung und Limitationen dieser Medikamentengruppe gegeben.

 

  • Literatur

  • 1 Schlatter P, Beglinger C, Drewe J. et al Glucagon-like peptide 1 receptor expression in primary porcine proximal tubular cells. Regul Pept 2007; 141: 120-128 doi:10.1016/j.regpep. 2006.12.016
    CrossrefPubMedGoogle Scholar
  • 2 Pyke C, Heller RS, Kirk RK. et al GLP-1 receptor localization in monkey and human tissue: novel distribution revealed with extensively validated monoclonal antibody. Endocrinology 2014; 155: 1280-1290 doi:10.1210/en.2013-1934
    CrossrefPubMedGoogle Scholar
  • 3 Körner M, Stöckli M, Waser B. et al GLP-1 receptor expression in human tumors and human normal tissues: potential for in vivo targeting. J Nucl Med 2007; 48: 736-743 doi:10.2967/jnumed.106.038679
    CrossrefPubMedGoogle Scholar
  • 4 Gutzwiller JP, Tschopp S, Bock A. et al Glucagon-like peptide 1 induces natriuresis in healthy subjects and in insulin-resistant obese men. J Clin Endocrinol Metab 2004; 89: 3055-3061 doi:10.1210/jc.2003-031403
    CrossrefPubMedGoogle Scholar
  • 5 Greco EV, Russo G, Giandalia A. et al GLP-1 receptor agonists and kidney protection. Medicina (Kaunas) 2019; 55: pii: E233 doi:10.3390/medicina55060233
    CrossrefPubMedGoogle Scholar
  • 6 Weyrich P, Schätzle G, Maljkovic M. et al Dialyse bei Diabetes. Dialyse aktuell 2018; 22: 225-229 doi:10.1055/a-0628-9789
    Article in Thieme ConnectGoogle Scholar
  • 7 Pfeffer MA, Claggett B, Diaz R. et al Lixisenatide in patients with type 2 diabetes and acute coronary syndrome. N Engl J Med 2015; 373: 2247-2257 doi:10.1056/NEJMoa1509225
    CrossrefPubMedGoogle Scholar
  • 8 Muskiet MHA, Tonneijck L, Huang Y. et al Lixisenatide and renal outcomes in patients with type 2 diabetes and acute coronary syndrome: an exploratory analysis of the ELIXA randomised, placebo-controlled trial. Lancet Diabetes Endocrinol 2018; 6: 859-869 doi:10.1016/S2213-8587(18)30268-7
    CrossrefPubMedGoogle Scholar
  • 9 Marso SP, Bain SC, Consoli A. et al Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med 2016; 375: 1834-1844 doi:10.1056/NEJMoa1607141
    CrossrefPubMedGoogle Scholar
  • 10 Zelniker TA, Wiviott SD, Raz I. et al Comparison of the effects of glucagon-Like peptide receptor agonists and sodium-glucose cotransporter 2 inhibitors for prevention of major adverse cardiovascular and renal outcomes in type 2 diabetes mellitus. Circulation 2019; 139: 2022-2031 doi:10.1161/CIRCULATIONAHA.118.038868
    CrossrefPubMedGoogle Scholar
  • 11 Davies MJ, Bain SC, Atkin SL. et al Efficacy and safety of liraglutide versus placebo as add-on to glucose-lowering therapy in patients with type 2 diabetes and moderate renal impairment (LIRA-RENAL): A randomized clinical trial. Diabetes Care 2016; 39: 222-230 doi:10.2337/dc14-2883
    CrossrefPubMedGoogle Scholar
  • 12 Mann JFE, Ørsted DD, Brown-Frandsen K. et al Liraglutide and renal outcomes in type 2 diabetes. N Engl J Med 2017; 377: 839-848 doi:10.1056/NEJMoa1616011
    CrossrefPubMedGoogle Scholar
  • 13 Holman RR, Bethel MA, Mentz RJ. et al Effects of once-weekly exenatide on cardiovascular outcomes in type 2 diabetes. N Engl J Med 2017; 377: 1228-1239 doi:10.1056/NEJMoa1612917
    CrossrefPubMedGoogle Scholar
  • 14 Bethel MA, Mentz RJ, Merrill P. et al Microvascular and cardiovascular outcomes according to renal function in patients treated with once-weekly exenatide: Insights from the EXSCEL trial. Diabetes Care 2020; 43: 446-452 doi:10.2337/dc19-1065
    CrossrefPubMedGoogle Scholar
  • 15 van Baar MJB, van Raalte DH, Muskiet MHA. GLP-1 receptor agonists, CKD, and eGFR trajectory. Lancet Diabetes Endocrinol 2018; 6: 764-765 doi:10.1016/S2213-8587(18)30241-9
    CrossrefPubMedGoogle Scholar
  • 16 Tuttle KR, Lakshmanan MC, Rayner B. et al Dulaglutide versus insulin glargine in patients with type 2 diabetes and moderate-to-severe chronic kidney disease (AWARD-7): a multicentre, open-label, randomised trial. Lancet Diabetes Endocrinol 2018; 6: 605-617 doi:10.1016/S2213-8587(18)30104-9
    CrossrefPubMedGoogle Scholar
  • 17 Idorn T, Knop FK, Jørgensen MB. et al Safety and efficacy of liraglutide in patients with type 2 diabetes and end-stage renal disease: An investigator-initiated, placebo-controlled, double-blind, parallel-group, randomized trial. Diabetes Care 2016; 39: 206-213 doi:10.2337/dc15-1025
    CrossrefPubMedGoogle Scholar
  • 18 Boye KS, Botros FT, Haupt A. et al Glucagon-like peptide-1 receptor agonist use and renal impairment: A retrospective analysis of an electronic health records database in the U.S. population. Diabetes Ther 2018; 9: 637-650 doi:10.1007/s13300-018-0377-5
    CrossrefPubMedGoogle Scholar
  • 19 Goud A, Zhong J, Peters M. et al GLP-1 agonists and blood pressure: A review of the evidence. Curr Hypertens Rep 2016; 18: 16 doi:10.1007/s11906-015-0621-6
    CrossrefPubMedGoogle Scholar
  • 20 Buse JB, Wexler DJ, Tsapas A. et al 2019 update to: Management of hyperglycaemia in type 2 diabetes, 2018. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia 2020; 63: 221-228 doi:10.1007/s00125-019-05039-w
    CrossrefPubMedGoogle Scholar