Physiology and pathophysiology of incretins in the kidney.
Curr Opin Nephrol Hypertens
; 23(1): 54-60, 2014 Jan.
Article
en En
| MEDLINE
| ID: mdl-24257158
ABSTRACT
PURPOSE OF REVIEW Incretin-based therapy with glucagon-like peptide-1 receptor (GLP-1R) agonists and dipeptidyl peptidase-4 (DPP-4) inhibitors is considered a promising therapeutic option for type 2 diabetes mellitus. Cumulative evidence, mainly from preclinical animal studies, reveals that incretin-based therapies also may elicit beneficial effects on kidney function. This review gives an overview of the physiology, pathophysiology, and pharmacology of the renal incretin system. RECENT FINDINGS:
Activation of GLP-1R in the kidney leads to diuretic and natriuretic effects, possibly through direct actions on renal tubular cells and sodium transporters. Moreover, there is evidence that incretin-based therapy reduces albuminuria, glomerulosclerosis, oxidative stress, and fibrosis in the kidney, partially through GLP-1R-independent pathways. Molecular mechanisms by which incretins exert their renal effects are understood incompletely, thus further studies are needed.SUMMARY:
The GLP-1R and DPP-4 are expressed in the kidney in various species. The kidney plays an important role in the excretion of incretin metabolites and most GLP-1R agonists and DPP-4 inhibitors, thus special attention is required when applying incretin-based therapy in renal impairment. Preclinical observations suggest direct renoprotective effects of incretin-based therapies in the setting of hypertension and other disorders of sodium retention, as well as in diabetic and nondiabetic nephropathy. Clinical studies are needed in order to confirm translational relevance from preclinical findings for treatment options of renal diseases.
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Receptores de Glucagón
/
Dipeptidil Peptidasa 4
/
Diabetes Mellitus Tipo 2
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Nefropatías Diabéticas
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Inhibidores de la Dipeptidil-Peptidasa IV
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Incretinas
/
Riñón
Límite:
Animals
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Humans
Idioma:
En
Revista:
Curr Opin Nephrol Hypertens
Asunto de la revista:
ANGIOLOGIA
/
NEFROLOGIA
Año:
2014
Tipo del documento:
Article
País de afiliación:
Alemania