Therapie der chronischen Niereninsuffizienz bei Diabetes mellitus

Zusammenfassung

Die Therapie der chronischen Niereninsuffizienz (CKD) bei Diabetes mellitus (DM) fokussierte sich bisher auf die Gabe von Angiotensin-Converting-Enzyme-Hemmern (ACE-Hemmern) oder Angiotensin-II-Rezeptor-Subtyp-1-Antagonisten (AT₁-Antagonisten). Weiterhin erfolgte die Kontrolle von Risikofaktoren wie Hyperglykämie, arterieller Hypertonie und Hyperlipidämie. Mit Natrium-Glukose-Kotransporter-2-Inhibitoren (SGLT-2i), Glukagonähnliches-Peptid-1-Rezeptor-Agonisten (GLP-1-RA) und einem nichtsteroidalen Mineralokortikoid-Rezeptor-Agonisten stehen neue Therapieoptionen zur Verfügung, die kardiorenale Endpunkte verbessern. Weitere Medikamentenklassen wie Endothelin-Rezeptor-Antagonisten, Aldosteron-Synthetase-Inhibitoren und Inkretin-Hormon-Therapeutika befinden sich in der klinischen Erprobung. Durch die Vielzahl der neuen Optionen wird die zukünftige Herausforderung in der Individualisierung der Therapie und Identifikation von Hochrisikopatienten liegen.

Publication History

Article published online:
21 July 2025

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