TY - JOUR
T1 - Transforming the care of patients with diabetic kidney disease
AU - Brosius, Frank C.
AU - Cherney, David
AU - Gee, Patrick O.
AU - Harris, Raymond C.
AU - Kliger, Alan S.
AU - Tuttle, Katherine R.
AU - Quaggin, Susan E.
N1 - Funding Information:
A.S. Kliger reports employment with Metabolism Associates, New Haven; reports having consultancy agreements with ASN; reports receiving honoraria from several universities and medical schools, professional organizations for lectures, seminars, and webi-nars; and reports other interests/relationships with ASN and Renal Physicians Association. D. Cherney reports consultancy agreements with Abbvie, AstraZeneca, Boehringer Ingelheim-Lilly, Janssen, Merck, Mitsubishi-Tanabe, NovoNordisk, Prometic, and Sanofi; reports receiving research funding from AstraZeneca, Boehringer Ingelheim-Lilly, Janssen, Merck, Novo Nordisk, and Sanofi; reports receiving honoraria from Abbvie, Astellas, AstraZeneca, Boehringer Ingelheim, JNJ, Lilly, Merck, Novo Nordisk, Otsuka, Prometic, and Sanofi; and reports serving as a scientific advisor or member of AstraZeneca, Boehringer Ingelheim, Janssen, Merck, Novo Nordisk, and Sanofi. F.C. Brosius reports receiving honoraria from various universities, serving as an Associate Editor of Diabetes, and serving on the Editorial Boards of American Journal of Physiology and Journal of Clinical Investigation. Gilead Sciences, Inc. has contracted with the University of Michigan for F. Brosius’s consultative services regarding diabetic nephropathy, and all funds go to the university. K.R. Tuttle reports consultancy agreements with AstraZeneca, Bayer, Boehringer Ingelheim, Eli Lilly, Gilead, Goldfinch Bio, and Novo Nordisk; receiving research funding from Bayer and Goldfinch Bio; receiving honoraria from Bayer, Gilead, and Goldfinch Bio; and serving as a scientific advisor or member of CJASN, Lancet Diabetes Endocrinology, Nature Reviews Nephrology, National Institute of Diabetes and Digestive and Kidney Diseases, and Kidney Health Initiative. P.O. Gee is the founder of iAdvocate, Inc., a nonprofit organization; reports receiving honoraria from APOLLO APOL1 Long-term Kidney Transplantation Outcomes Consortium Community Advisory Council, Bayer International, CareDX, Center for Disease Innovation Patient Advisory Board/Kidney Research Institute Patient Advisory Committee, Otsuka Pharmaceutical Advisory Board, Patient Family Advisors Network, and Vertex International; reports serving as a scientific advisor or member of AAKP BOD, APOLLO Steering Committee’s Community Advisory Council, ESRD Network 5 MRB, Otsuka Pharmaceuticals Advisory Board, and University of Washington Center for Dialysis Innovation Patient Advisory Board and the Human Factors Working Group Member and PFCC partners Advisory Board; other interests/relationships include AAKP Ambassador, AKF Ambassador and Kidney Health Coach, ASN Diabetic Kidney Disease-Collaborative Task Force, KHI PFPC Member, KPAC Member, NKF KAC, NCC PFE-LAN SME, PCORI Ambassador, PFA Network Advisors Diversity, Equity, and Inclusion Workgroup, Quality Insights Renal Network 5 PAC Chair, and UNOS Ambassador. R.C. Harris reports consultancy agreements with, and receiving research funding from, Bayer; reports receiving honoraria from University of California Los Angeles; reports patents and inventions with eNOS db/db mouse; and reports serving as a scientific advisor or member of Bayer Scientific Advisory Board. S.E. Quaggin reports consultancy agreements with AstraZeneca, Genentech, Goldfinch, Janssen, Lowy Medical Research Foundation, Novartis, and Roche; reports having an ownership interest in Mannin Research; reports receiving research funding from AstraZeneca and Mannin Research; reports receiving honoraria from Korean Scientific plenary lecture; and reports serving as a scientific advisor or member of AstraZeneca, Genentech/Roche, JCI, Karolinska CVRM Institute, Lowy Medical Research Institute, Mannin, and Novartis, and being Chief Scientific Officer and founder of Mannin Research.
Funding Information:
The work is supported by the National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases P30DK114857 (to S.E. Quaggin).
Publisher Copyright:
© 2021 by the American Society of Nephrology.
PY - 2021/10
Y1 - 2021/10
N2 - Diabetes and its associated complications pose an immediate threat to humankind. Diabetic kidney disease is one of the most devastating complications, increasing the risk of death more than ten-fold over the general population. Until very recently, the only drugs proven and recommended to slow the progression of diabetic kidney disease were angiotensin-converting enzyme inhibitors and angiotensin II type 1 receptor blockers, which act by inhibiting the renin-angiotensin system. Despite their efficacy as kidney and cardiovascular protective therapies and as antihypertensive agents, renin-angiotensin system inhibitors have been grossly underutilized.Moreover, even when renin-angiotensin system inhibitors are used, patients still have a high residual risk of diabetic kidney disease progression. Finally, the kidney-protective effect of renin-angiotensin systeminhibitors has been categorically demonstrated only in patients with macroalbuminuria included in the IrbesartanDiabeticNephropathy Trial (IDNT) and Reduction of Endpoints inNIDDMwith the Angiotensin II Antagonist Losartan (RENAAL) trials, not in other individuals.The lack of newtherapies to treat diabetic kidney disease over the past 2 decades has therefore represented a tremendous challenge for patients and health care providers alike. In recent years, a number of powerful new therapies have emerged that promise to transform care of patients with diabetes and kidney disease. The challenge to the community is to ensure rapid implementation of these treatments. This white paper highlights advances in treatment, opportunities for patients, challenges, and possible solutions to advance kidney health, and introduces the launch of the Diabetic Kidney Disease Collaborative at the American Society of Nephrology, to aid in accomplishing these goals.
AB - Diabetes and its associated complications pose an immediate threat to humankind. Diabetic kidney disease is one of the most devastating complications, increasing the risk of death more than ten-fold over the general population. Until very recently, the only drugs proven and recommended to slow the progression of diabetic kidney disease were angiotensin-converting enzyme inhibitors and angiotensin II type 1 receptor blockers, which act by inhibiting the renin-angiotensin system. Despite their efficacy as kidney and cardiovascular protective therapies and as antihypertensive agents, renin-angiotensin system inhibitors have been grossly underutilized.Moreover, even when renin-angiotensin system inhibitors are used, patients still have a high residual risk of diabetic kidney disease progression. Finally, the kidney-protective effect of renin-angiotensin systeminhibitors has been categorically demonstrated only in patients with macroalbuminuria included in the IrbesartanDiabeticNephropathy Trial (IDNT) and Reduction of Endpoints inNIDDMwith the Angiotensin II Antagonist Losartan (RENAAL) trials, not in other individuals.The lack of newtherapies to treat diabetic kidney disease over the past 2 decades has therefore represented a tremendous challenge for patients and health care providers alike. In recent years, a number of powerful new therapies have emerged that promise to transform care of patients with diabetes and kidney disease. The challenge to the community is to ensure rapid implementation of these treatments. This white paper highlights advances in treatment, opportunities for patients, challenges, and possible solutions to advance kidney health, and introduces the launch of the Diabetic Kidney Disease Collaborative at the American Society of Nephrology, to aid in accomplishing these goals.
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U2 - 10.2215/CJN.18641120
DO - 10.2215/CJN.18641120
M3 - Article
C2 - 34103350
AN - SCOPUS:85117372605
SN - 1555-9041
VL - 16
SP - 1590
EP - 1600
JO - Clinical Journal of the American Society of Nephrology
JF - Clinical Journal of the American Society of Nephrology
IS - 10
ER -