Recent therapeutic advancements for diabetic kidney disease, including SGLT2 inhibitors, GLP1 receptor agonists, and non-steroidal MRAs, provide cardiorenal benefits equally to elderly and non-elderly patients.
This review outlines a comprehensive management strategy for elderly patients with diabetic kidney disease, emphasizing the applicability and cardiorenal benefits of newer pharmacological agents like SGLT2 inhibitors.
Diabetes mellitus (DM) and chronic kidney disease (CKD) are common in middle aged and elderly individuals. DM may accelerate the aging process, and the age-related declines in the estimated Glomerular Filtration Rate (eGFR), can pose a challenge to diagnose diabetic kidney disease (DKD) using standard diagnostic criteria especially with absence of severe albuminuria among the elderly. In the presence of CKD and DM, elderly patients may need multidisciplinary care due to susceptibility to various health issues e.g., cognitive decline, auditory or visual impairment, various comorbidities, complex medical regimens, and increased sensitivity to medication adverse effects. As a result, it can be challenging to apply recent therapeutic advancements for the general population to the elderly. We review the evidence that the benefits from these newer therapies apply equally to elderly and non-elderly patients and propose a framework for the management of DKD by discussing the nonpharmacological measures and pharmacological management with renin angiotensin system inhibitors (RASi), Sodium Glucose Co-Transporter two inhibitors (SGLT2i), non-steroidal mineralocorticoids receptor antagonists (MRAs), and Glucagon Like Peptide 1 Receptor Agonists (GLP1-RAs).
Ravender et al. (Mon,) conducted a review in Chronic Kidney Disease in Diabetes. SGLT2 inhibitors, GLP1 receptor agonists, non-steroidal MRAs, and RAS inhibitors was evaluated. Recent therapeutic advancements for diabetic kidney disease, including SGLT2 inhibitors, GLP1 receptor agonists, and non-steroidal MRAs, provide cardiorenal benefits equally to elderly and non-elderly patients.