肠促胰岛素
医学
肾脏疾病
糖尿病
胰高血糖素
内科学
药理学
内分泌学
2型糖尿病
胰岛素
作者
Brandon E. McFarlin,Kevin L. Duffin,Anish Konkar
出处
期刊:American Journal of Physiology-endocrinology and Metabolism
[American Physiological Society]
日期:2024-03-13
标识
DOI:10.1152/ajpendo.00374.2023
摘要
Chronic kidney disease (CKD) is a debilitating condition associated with significant morbidity and mortality. In recent years, the kidney effects of incretin-based therapies, particularly glucagon-like peptide-1 receptor agonists (GLP-1RAs), have garnered substantial interest in the management of type 2 diabetes (T2D) and obesity. This review delves into the intricate interactions between the kidney, GLP-1RAs, and glucagon, shedding light on their mechanisms of action and potential kidney benefits. Both GLP-1 and glucagon, known for their opposing roles in regulating glucose homeostasis, improve systemic risk factors affecting the kidney, including adiposity, inflammation, oxidative stress, and endothelial function. Additionally, these hormones and their pharmaceutical mimetics may have direct impact on the kidney. Clinical studies have provided evidence that incretins, including those incorporating glucagon receptor agonism, are likely to exhibit improved kidney outcomes. Although further research is necessary, receptor polypharmacology holds promise for preserving kidney function through eliciting vasodilatory effects, influence on volume and electrolyte handling, and improvement of systemic risk factors.
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