2. Academic Validation
  3. Targeting inflammation to treat diabetic kidney disease: the road to 2030

Targeting inflammation to treat diabetic kidney disease: the road to 2030

  • Kidney Int. 2022 Dec 5;S0085-2538(22)01017-1. doi: 10.1016/j.kint.2022.10.030.
Sandra Rayego-Mateos 1,  Raul R Rodrigues-Diez 2,  Beatriz Fernandez-Fernandez 3,  Carmen Mora-Fernández 4,  Vanessa Marchant 1,  Javier Donate-Correa 4,  Juan F Navarro-González 5,  Alberto Ortiz 3,  Marta Ruiz-Ortega 6
Affiliations

Affiliations

  • 1 Cellular Biology in Renal Diseases Laboratory, IIS-Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain; Ricord2040, Instituto de Salud Carlos II, Spain.
  • 2 Ricord2040, Instituto de Salud Carlos II, Spain; Translational Immunology, Instituto de Investigación Sanitaria del Principado de Asturias ISPA, Oviedo, Asturias, Spain.
  • 3 Ricord2040, Instituto de Salud Carlos II, Spain; Division of Nephrology and Hypertension, IIS-Fundación Jiménez Díaz-Universidad Autónoma, Madrid, Spain.
  • 4 Ricord2040, Instituto de Salud Carlos II, Spain; Research Unit, University Hospital Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain.
  • 5 Ricord2040, Instituto de Salud Carlos II, Spain; Research Unit, University Hospital Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain; Nephrology Service, University Hospital Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain.
  • 6 Cellular Biology in Renal Diseases Laboratory, IIS-Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain; Ricord2040, Instituto de Salud Carlos II, Spain. Electronic address: mruizo@fjd.es.
PMID: 36470394 DOI: 10.1016/j.kint.2022.10.030
Abstract

Diabetic kidney disease (DKD) is one of the fastest growing causes of chronic kidney disease and associated morbidity and mortality. Preclinical research has demonstrated the involvement of inflammation in its pathogenesis and in the progression of kidney damage, supporting clinical trials designed to explore anti-inflammatory strategies. However, the recent success of sodium-glucose cotransporter-2 inhibitors and the nonsteroidal Mineralocorticoid Receptor Antagonist finerenone has changed both guidelines and standard of care, rendering obsolete older studies directly targeting inflammatory mediators and the clinical development was discontinued for most anti-inflammatory drugs undergoing clinical trials for DKD in 2016. Given the contribution of inflammation to the pathogenesis of DKD, we review the impact on kidney inflammation of the current standard of care, therapies undergoing clinical trials, or repositioned drugs for DKD. Moreover, we review recent advances in the molecular regulation of inflammation in DKD and discuss potential novel therapeutic strategies with clinical relevance. Finally, we provide a road map for future research aimed at integrating the growing knowledge on inflammation and DKD into clinical practice to foster improvement of patient outcomes.

Keywords

SGLT2; chronic kidney disease; clinical trials; diabetes; diabetic kidney disease; finerenone; inflammation.

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