ISSN 1006-298X      CN 32-1425/R

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肾脏病与透析肾移植杂志 ›› 2022, Vol. 31 ›› Issue (5): 470-474.DOI: 10.3969/j.issn.1006-298X.2022.05.015

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糖尿病肾病药物治疗的现状和进展

  

  • 出版日期:2022-10-28 发布日期:2022-10-22

Present and future of therapeutic drugs for diabetic kidney diseases

  • Online:2022-10-28 Published:2022-10-22

摘要: 糖尿病肾病(DKD)是导致终末期肾病的主要病因。临床上DKD的主要治疗手段是基于肾素血管紧张素系统抑制剂、钠葡萄糖共转运蛋白2抑制剂的多学科综合治疗。近年来,胰促肠素等相关药物在许多临床试验中显示出了肾脏保护作用。治疗肾性贫血的缺氧诱导因子脯氨酸羟化酶抑制剂也能通过改善肾小管间质缺氧发挥DKD的肾脏保护作用。此外,核因子E2相关因子2激动剂、糖基化终末产物抑制剂等一些新型药物也可能具有潜在的DKD治疗效果。肾脏表观遗传调控在DKD肾损伤和肾功能恶化中发挥重要作用,组蛋白修饰抑制剂等具有表观调控作用的分子药物未来也有可能成为DKD干预治疗的新途径。


关键词: 糖尿病肾病, 治疗, 糖基化终末产物, 表观遗传调控

Abstract: Diabetic kidney disease (DKD) is the main cause of endstage renal disease. At present, multidisciplinary therapeutic strategies based on reninangiotensin system inhibitors and sodiumglucose cotransporter 2 inhibitors is effective for DKD. In recent years, incretinrelated drugs have reported renal function protection in clinical trials. Hypoxiainducible factor prolyl hydroxylase inhibitors may be renoprotective since they improve tubulointerstitial hypoxia. In addition, new drugs, including NFE2related factor 2 agonists, glycation end products (AGE) inhibitors, may also have potential therapeutic effects in DKD. Epigenetic regulation plays an critical role in renal injury and renal function progression in DKD. Molecules with epigenetic regulation such as histone modification inhibitors may become a new way of intervention for DKD in the future.


Key words: diabetic kidney diseases, therapy, glycation end products, epigenetic regulation