How To Manage And Slow Down Kidney Disease

Approximately 37 million American adults have chronic kidney disease. Ongoing research continues to uncover ways to help slow down this disease with new treatment choices. Here are the current methods for reducing disease progression: SGLT2 inhibitors, GLP-1 agonists and mineralocorticoid receptor antagonists.

SGLT2 Inhibitors

These are a group of medications that are used to treat type 2 diabetes and chronic kidney disease. They work by blocking the reabsorption of glucose in the kidneys. This leads to increased glucose output in the urine, which results in lower blood sugar levels. SGLT2 inhibitors can slow the progression of kidney damage and reduce cardiovascular events.

These medications are not a cure but can help manage kidney and heart health. “The benefits are even stronger for people who also have albuminuria. SGLT2 inhibitors can also help people with other causes of kidney disease, including glomerular diseases like IgA nephropathy.”

SGLT2 inhibitors help patients with kidney disease by lowering blood sugar and blood pressure, as well as directly protecting the kidneys from damage. They also reduce inflammation and fibrosis, which improves kidney health.

Medications available:

• Canagliflozin (Invokana)

• Dapagliflozin (Farxiga)

• Empagliflozin (Jardiance)

GLP-1 Agonists

This class of medications is used to treat type 2 diabetes and obesity. But they also help kidney disease by improving blood sugar levels, lowering blood pressure, and reducing the inflammation and scarring in the kidneys. They also help reduce the risk of a heart attack or stroke. They work by mimicking the effects of a natural hormone produced in the body, called GLP-1.

Clinical trials have shown that GLP-1 agonists can significantly slow the progression of kidney disease and lower the risk of kidney failure. They can restore normal blood flow within the kidneys, which helps protect against damage.

Medications available:

• Exenatide (Byetta, Bydureon)

• Liraglutide (Saxenda, Victoza)

• Semaglutide (Ozempic, Wegovy)

• Dulaglutide (Trulicity)

• Tirzepatide (Mounjaro, Zepbound)

Mineralocorticoid Receptor Antagonists (MRAs)

These are a class of medications that block the effects of the hormone, aldosterone. This hormone helps regulate blood pressure and electrolytes. These receptors are found in tissues like the brain, kidneys, heart, and blood vessels. They cause the kidneys to excrete salt and water. This helps to lower blood pressure.

MRAs primarily treat hypertension, heart failure, and kidney disease. Precautions should be taken for patients with kidney disease, liver disease, and those with high potassium levels.

MRAs can help with kidney disease by reducing inflammation and fibrosis, which helps protect the kidneys and slow down kidney disease. They also decrease the risk of cardiovascular events, which are a common complication.

Medications available:

• Spironolactone (Aldactone, CaroSpir)

• Eplerenone (Inspra)

• Finerenone (Kerendia)

Overview

Although chronic kidney disease is generally progressive and irreversible, there are steps patients can take to slow progression. These options enable patients to live longer without complications. Any medication decisions should be made with your doctor.

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