Improving kidney protection in patients with type 2 diabetes
Chronic kidney disease affects millions of people worldwide. This is associated with a high burden of disease and health care utilisation. The need for new treatments to slow down (further) deterioration of kidney function is therefore of great importance.Sodium glucose co-transporter 2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists are two relatively new classes of drugs. Both SGLT2 inhibitors and GLP-1 receptor agonists were initially developed to lower blood sugar levels in patients with diabetes mellitus. However, both types of drugs were also found to have a protective effect on the kidneys. The mechanism behind these beneficial effects on the kidneys, and which patients benefit most from these drugs, is not yet fully known.The research in this thesis contributes to our understanding of the action of SGLT2 inhibitors and GLP-1 receptor agonists. The challenge for the near future will be to determine how best to use the available treatment options (i.e. who will benefit most from which drug), and what is the best treatment strategy for patients who are not responding adequately to the prescribed treatment.