Pioglitazone in diabetic kidney disease: forgotten but not gone

Papaetis, Georgios S.

doi:10.5114/amsad/151046

Cited by 8 publications

(16 citation statements)

References 173 publications

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“…Jego bezpośrednie działanie może polegać na poprawie hiperfiltracji, klirensu kreatyniny, hamowaniu przebudowy tętniczek przedkłębuszkowych oraz stymulacji endogennych komórek macierzystych nerek i zwiększaniu wychwytu albumin w kanalikach nerkowych. Możliwe mechanizmy ochrony przed cukrzycową chorobą nerek obejmują również działanie przeciwzwłóknieniowe, przeciwzapalne, hamujące proliferację komórek i apoptozę [31].…”

Section: Nefroprotekcyjne Działanie Pioglitazonuunclassified

Pioglitazone - the forgotten drug with multidirectional action

Arkadiusz¹,

Julia²

2023

J Educ Health Sport

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Introduction: Pioglitazone (PG) which belongs to thiazolidinedione class is a drug used in the treatment of type 2 diabetes. PG increases the insulin sensitivity of peripheral tissues. Type 2 diabetes mellitus (T2DM) is one of the most common and fastest developing diseases. The antihyperglycemic effect of pioglitazone (PG) is not its only one. This drug has a number of other metabolically beneficial effects. Many outcome trials indicate a positive impact of PG on the functioning of other systems. Aim of the study: The aim of this study is to summarize the current knowledge on the effectiveness and safety of pioglitazone based on the available scientific literature. Materials and methods: Literature review based on PubMed, Google Scholar database using the following phrases: pioglitazone, type 2 diabetes, pioglitazone in non-alcoholic fatty liver disease (NAFLD) therapy, pioglitazone and cardiovascular risk, pioglitazone nephroprotective effect, pioglitazone safety profile. State of knowledge: Pioglitazone is an oral antidiabetic drug used in the therapy of T2DM. PG belongs to the ‘insulin- sensitizers’. It is included in the treatment in the case of intolerance, contraindications to metformin or as part of combination therapy. Conclusions: Recently, interest in pioglitazone has waned due to the perception of significant side effects. The analysis of the papers showed a positive effect of PG on the cardiovascular system, central nervous system, NAFLD and nephroprotection. The acceptable safety profile of pioglitazone with the appropriate selection of patients as well as its multidirectional action and effectiveness mean that clinicians should reconsider the use of this drug guided by the balance of profits and losses.

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Section: Nefroprotekcyjne Działanie Pioglitazonuunclassified

Pioglitazone - the forgotten drug with multidirectional action

Arkadiusz¹,

Julia²

2023

J Educ Health Sport

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“…It is estimated that approximately 783.2 million people worldwide will be diagnosed with diabetes in the year 2045, while the projection for the year 2050 suggests that one in three individuals will experience some type of diabetes [1][2][3][4]. Approximately, 5% of all patients with diabetes are diagnosed with type 1 diabetes (T1D) and the rest 90-95% with type 2 diabetes (T2D).…”

Section: Introductionmentioning

confidence: 99%

Insulin degludec in pregestational diabetes: evidence and perspectives

Papaetis,

Mikellidis

2024

Arch Med Sci Atheroscler Dis

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Pregestational diabetes is described when a woman with diabetes before the onset of pregnancy becomes pregnant and consequently she is vulnerable to higher risk for adverse outcomes in the embryo/foetus. Strict glycaemic control, with minimal glucose variability, starting from before conception and maintained throughout pregnancy decreases significantly adverse foetal and maternal outcomes; maternal hypoglycaemic episodes are the major barrier in achieving this goal. Insulin degludec is an ultralong-acting analogue, which has half-life of over 25 h and full duration of effect of more than 42 h, reaching a steady-state serum concentration after 2–3 days of its administration. It promotes flat, steady, peakless and predictable insulin concentrations, with minor intra-individual and inter-individual variability. It also exerts a low mitogenic/metabolic potency ratio. This review examines thoroughly all current evidence of the administration of insulin degludec in pregestational diabetes as well as its future role in this population.

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“…Diabetic kidney disease (DKD) (also defined as diabetic nephropathy or chronic kidney disease (CKD)] due to diabetes) is found in approximately 20-40% of all diabetic patients; it is related to higher mortality (cardiovascular and all-cause) [1]. The final manifestations of its evolution are glomerulosclerosis in interplay with tubulointerstitial scarring [1,2]. Although DKD classically presents with proteinuria, followed by progressive kidney decline, a remarkable percentage of patients with type 2 diabetes (T2D) experience reduced renal function without proteinuria (known as non-proteinuric DKD) [3].…”

Section: Introductionmentioning

confidence: 99%

“…Although DKD classically presents with proteinuria, followed by progressive kidney decline, a remarkable percentage of patients with type 2 diabetes (T2D) experience reduced renal function without proteinuria (known as non-proteinuric DKD) [3]. This renal phenotype is clinically and pathologically heterogenous; intrarenal atherosclerosis is a key player in its pathogenesis and development [2,3].…”

Section: Introductionmentioning

confidence: 99%

SGLT2 inhibitors, intrarenal hypoxia and the diabetic kidney: insights into pathophysiological concepts and current evidence

Papaetis

2024

Arch Med Sci Atheroscler Dis

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Approximately 20–40% of all diabetic patients experience chronic kidney disease, which is related to higher mortality (cardiovascular and all-cause). A large body of evidence suggests that renal hypoxia is one of the main forces that drives diabetic kidney disease, both in its early and advanced stages. It promotes inflammation, generation of intrarenal collagen, capillary rarefaction and eventually accumulation of extracellular matrix that destroys normal renal architecture. SGLT2 inhibitors are unquestionably a practice-changing drug class and a valuable weapon for patients with type 2 diabetes and chronic kidney disease. They have achieved several beneficial kidney effects after targeting multiple and interrelated signaling pathways, including renal hypoxia, independent of their antihyperglycemic activities. This manuscript discusses the pathophysiological concepts that underly their possible effects on modulating renal hypoxia. It also comprehensively investigates both preclinical and clinical studies that explored the possible role of SGLT2 inhibitors in this setting, so as to achieve long-term renoprotective benefits.

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Pioglitazone in diabetic kidney disease: forgotten but not gone

Cited by 8 publications

References 173 publications

Pioglitazone - the forgotten drug with multidirectional action

Pioglitazone - the forgotten drug with multidirectional action

Insulin degludec in pregestational diabetes: evidence and perspectives

SGLT2 inhibitors, intrarenal hypoxia and the diabetic kidney: insights into pathophysiological concepts and current evidence

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