Catch it all: Review of new advances in the treatment of chronic kidney disease

How to treat chronic kidney disease and what new progress has been made? I will introduce them to you one by one.

At the just-concluded 60th European Congress of Nephrology, major advances in the field of kidney disease over the past year were recognized. Among them, there were 6 clinical studies involving kidney disease treatment. Let me tell you about them one by one.

1. Kidney disease research of empagliflozin: It proves that empagliflozin has therapeutic effects on non-diabetic kidney disease in addition to diabetic kidney disease, and can delay the progression of kidney disease and prevent acute kidney injury. Prior to this, dapagliflozin has also been proven to be effective in treating non-diabetic kidney disease. This study of empagliflozin actually verifies and repeats the results of dapagliflozin.

In other words, hypoglycemic drugs such as levofloxacin can treat diabetic nephropathy, and also have therapeutic effects on non-diabetic nephropathy such as IgA nephropathy, membranous nephropathy, glomerulonephritis, hypertensive nephropathy, etc. Later, I understood why doctors prescribed hypoglycemic drugs such as levofloxacin to patients with nephritis without diabetes.

2. A series of studies on finerenone: It has been proven that finerenone can treat kidney disease, significantly reduce the progression of chronic kidney disease, and does not increase the risk of hyperkalemia.

3. Sparsentan for the treatment of IgA nephropathy: Sparsentan can significantly reduce the urine protein in patients with IgA nephropathy, and its effect is better than that of sartan antihypertensive drugs.

Sartan antihypertensive drugs are the basic drugs for IgA nephropathy, which can reduce urine protein and delay kidney damage. Sparsentan is a dual antagonist of endothelin and angiotensin II receptors, and its drug ingredients include sartan antihypertensive drugs.

4. Research on the effects of pril and sartan antihypertensive drugs on late-stage renal disease: Pril and sartan antihypertensive drugs can reduce urine protein and delay renal damage, and are the basic drugs for most kidney diseases. However, in some cases, these two types of drugs can cause a transient increase in blood creatinine, so patients with late-stage renal disease and progressive renal disease stop taking the drugs. This study found that stopping the drug does not reduce the increase in blood creatinine, but instead causes the kidneys and heart to lose protection, so sartan or pril antihypertensive drugs should not be stopped because of poor renal function.

5. Glomerular filtration rate measurement research: The study found that there is a large difference between the glomerular filtration rate (eGFR) measured based on blood creatinine and the glomerular filtration rate (mGFR) measured by the gold standard. Only in about 60% of cases, the two achieved consistent results. In other words, the glomerular filtration rate currently used and calculated by blood creatinine cannot accurately reflect renal function, and the relevant calculation formula needs to be further developed.

Patients often ask: Why does my kidney function change so quickly? This study tells us that rapid changes in GFR may be due to the disease or the calculation formula.

6. Research on the use of hydrochlorothiazide to prevent kidney stones: Studies have confirmed that hydrochlorothiazide cannot prevent the occurrence of kidney stones, and long-term use may also cause side effects.