GLP-1 RA : Efektivitas Terapi Dalam Mengurangi Komplikasi Mikrovaskular Organ Ginjal Pada Penderita Diabetes Melitus Tipe 2

Mohd Ilham Fat-Thur Rahman, Abdul Karim


Abstract


Diabetes melitus (DM) adalah kelainan metabolik kronis yang ditandai dengan hiperglikemia persisten. Data International Diabetes Federation (IDF), sekitar 415 juta orang dewasa berusia antara 20 hingga 79 tahun menderita diabetes mellitus. Tujuan penelitian ini adalah mendapatkan hasil penelitian dari kegiatan terapi dalam mengurangi komplikasi mikrosvaskular Organ Ginjal pada penderita DM tipe 2. Analisis post-hoc menunjukkan pengurangan albuminuria sebesar 30% dan regresi menjadi mikro- atau normoalbuminuria terjadi pada semua derajat albuminuria pada pasien yang diobati dengan semaglutide. Kesimpulan dari penelitian ini adalah Obat penurun glukosa tertentu telah menunjukkan manfaat. GLP-1RA dikaitkan dengan hasil fungsi ginjal yang lebih baik. Beberapa GLP-1RA mengurangi perkembangan albuminuria nyata, menurunkan albuminuria selama masa tindak lanjut, dan dapat menunda perkembangan disfungsi ginjal pada DKD, terutama pada subkelompok dengan CKD yang sudah terjadi

Keywords


Efektivitas, Terapi, Ginjal, Diabetes Melitus Tipe 2

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Davies MJ, Bain SC, Atkin SL, Rossing P, Scott D, Shamkhalova MS. Efficacy and Safety of Liraglutide Versus Placebo as Add-on to Glucose-Lowering Therapy in Patients With Type 2 Diabetes and Moderate Renal Impairment (LIRA-RENAL): A Randomized Clinical Trial. Diabetes Care 2015;39:222–230

DeFronzo RA. Pathogenesis Of Type 2 Diabetes: Metabolic And Molecular Implications For Identifying Diabetes Genes. Diabetes Rev. 2020;5:178-269

Drucker DJ. Mechanisms of action and therapeutic application of glucagon-like peptide-1. Cell Metab.2018;27;740-756

Drummond K, Mauer M; International Diabetic Nephropathy Study Group: The early natural history of nephropathy in type 2 diabetes: II. Early renal structural changes in type 2 diabetes. 2022;51:1580–1587

Farrington K, Covic A, Nistor I, Aucella F, Clyne N, de Vos L, et al. Clinical Practice Guideline On Management Of Older Patients With Chronic Kidney Disease Stage 3b Or Higher (eGFR &alt; 45 mL/min/1.73 m2): A summary Document From The European Renal Best Practice Group. Nephrol. Dial. Transplant. 2017;32:9–16.

Forbes JM, Cooper ME. Mechanisms Of Diabetic Complications. Physiological Reviews. 2019;93(1):137-188

Gorriz JL, Soler MJ, CArro CG, D’MArco L, Ortiz A. GLP-1 Receptor Agonists and Diabetic Kidney Disease: A Call of Attention to Nephrologists. J. Clin. Med. 2020;9(4):947

Górriz L, Soler MJ, Navarro-González, García-Carro, Puchades L. D’Marco, et al. GLP-1 Receptor Agonists And Diabetic Kidney Disease: a Call Of Attention To Nephrologists. J Clin Med. 9;2020:947

Hernandez AF, Green JB, Janmohamed S, D’Agostino RB, Granger CB, Jones NP, Leiter LA, et al. Albiglutide And Cardiovascular Outcomes In Patients With Type 2 Diabetes And Cardiovascular Disease (Harmony Outcomes): A Double-Blind, Randomised Placebo-Controlled Trial. Lancet 2018, 392, 1519–1529

Holman RR, Bethel MA, Mentz RJ, Thompson VP, Lokhnygina Y, Buse JB, Chan, JNC, Choi J, et al. Effects of Once-Weekly Exenatide on Cardiovascular Outcomes in Type 2 Diabetes. N. Engl. J. Med. 2017, 377, 1228–1239

Husain AL, Birkenfeld M, Donsmark K, Dungan FG, Eliaschewitz DR, Franco et al. Oral semaglutide and cardiovascular outcomes in patients with Type 2 diabetes. N Engl J Med, 2019;381:841-851

Marso SP, Daniels GH, Brown-Frandsen K, Kristensen, P, Mann, JF, Nauck, MA, Nissen SE, et al. Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes. N. Engl. J. Med. 2016, 375, 311–322.

Martínez-Castelao A, Górriz JL, Ortiz A, Navarro-González JF. ERBP Guideline On Management Of Patients With Diabetes And Chronic Kidney Disease Stage 3B Or Higher. Metformin For All. Nefrologia 2017:37; 567–571

Martínez-Castelao A, Górriz JL, Segura-de la Morena J, Cebollada J, Escalada J, Esmatjes E, Fácila L, Gamarra J, et al. Consensus Document For The Detection And Management Of Chronic Kidney Disease. Nefrologia 2014, 34, 243–262.

Muskiet HA, Tonneijck L, Huang L, Liu A, Saremi HJL, Heerspink, et al. Lixisenatide and renal outcomes in patients with type 2 diabetes and acute coronary syndrome: an exploratory analysis of the ELIXA randomised, placebo-controlled trial. Lancet Diabetes Endocrinol. 2018;6:859-869

Perkovic V, Jardine MJ, Neal B, Bompoint S, Heerspink HJL, Charytan DM, Edwards R, Agarwal R, et al. Canagliflozin And Renal Outcomes In Type 2 Diabetes And Nephropathy. N. Engl. J. Med. 2019, 380, 2295–2306.

Perley MJ, Kipsis DM. Plasma Insulin Responses To Oral And Intravenous Glucose: Studies In Normal And Diabetic Sujbjects. J Clin Invest,2019;3(1): 1954-1962

Pfeffer MA, Claggett B, Diaz R, Dickstein K, Gerstein HC et al. Lixisenatide in patients with type 2 diabetes and acute coronary syndrome. N. Engl. J. Med. 2015;373: 2247–2257.

Retnakaran R, Cull CA, Thorne KI, Adler AI, Holman RR; UKPDS Study Group: Risk factors for renal dysfunction in type 2 diabetes: U.K. Prospective Diabetes Study 74. Diabetes.2023;55: 1832–1839

Steven P. Marso , MD , Stephen C. Bain , MD , Agostino Consoli , MD , Freddy G. Eliaschewitz , MD , Esteban Jódar , MD , Lawrence A. Leiter , MD , Ildiko Lingvay , MD. Semaglutide And Cardiovascular Outcomes In Patients With Type 2 Diabetes. N Engl J Med, 375 (2016), pp. 1834-1844

Thomas CC, Philipson LH. Update On Diabetes Classification. Med Clin N Am 2019; 99:1-16.

Turnbull, FM, Abraira, C, Anderson, RJ, et al. Intensive glucose control and macrovascular outcomes in type 2 diabetes. Diabetologia 2019;52:2288-2298

Zhang F, Chen Z, Wu D, Tian L, Chen Y, et al. Recombinant human GLP-1 beinaglutide regulates lipid metabolism of adipose tissues in diet-induced obese mice. iScience. 2021;24

Zoungas, S, Arima, H, Gerstein, HC, et al. Effects of intensive glucose control on microvascular outcomes in patients with type 2 diabetes: a meta-analysis of individual participant data from randomised controlled trials. Lancet Diabetes Endocrinol .2017;5:431-437




DOI: https://doi.org/10.30743/best.v7i2.10352

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