Key result
Antihypertensive therapies like RAASi, SGLT2i, and newer MRAs delay diabetic kidney disease progression.
Why the study?
Hypertension is a critical component of cardiovascular disease progression in DKD, and clinicians continue to search for optimal care plans as newer agents emerge.
Do antihypertensive medications including RAAS inhibitors, SGLT2 inhibitors, and MRAs delay disease progression in patients with diabetic kidney disease?
Do antihypertensive medications including RAAS inhibitors, SGLT2 inhibitors, and MRAs delay disease progression in patients with diabetic kidney disease?
This review highlights the importance of blood pressure control and the use of RAAS inhibitors, SGLT2 inhibitors, and newer MRAs to delay progression of diabetic kidney disease.
Supports BP control with RAAS inhibitors, SGLT2 inhibitors, and MRAs in diabetic kidney disease; leaves open optimal sequencing and head-to-head trials.
Hypertension is a critical component of cardiovascular disease progression in patients with chronic kidney disease, and specifically diabetic kidney disease (DKD). Causation versus correlation remains up for debate, but what has been confirmed is the delay of DKD progression when hypertension is controlled or moved to guideline drive ranges. Many medications have been studied and used in real world experience for best outcomes, and we discuss below the proven winners thus far making up the renin angiotensin aldosterone system. As well, we discuss guideline changing medications including sodium-glucose cotransporter 2 inhibitors and newer generation mineralocorticoid receptor antagonists. With the growing prevalence of diabetes and DKD in the population, newer agents are emerging in multiple drug class and will be highlighted below. Clinicians continue to search for the optimal care plans for this challenging patient population.
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Colbert et al. (2023) conducted a review in Hypertension in Diabetic Kidney Disease. Antihypertensive medications (RAAS inhibitors, SGLT2 inhibitors, MRAs) was evaluated. Antihypertensive therapies, including RAAS inhibitors, SGLT2 inhibitors, and newer mineralocorticoid receptor antagonists, delay the progression of diabetic kidney disease.
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