Individualizing pharmacologic and non-pharmacologic therapy for CKD associated with diabetes
Clicks: 3
ID: 324364
2026
Article Quality & Performance Metrics
Overall Quality
Not rated
Combines reader engagement with the AI quality analysis. This
article has not been analysed, so there is no overall score —
reader engagement is measured and shown alongside.
Reader Engagement
0.0
/100
3 views
0 readers
AI Quality Assessment
Not analyzed
Readership in this journal
Ranked #22 of 94 articles by views in nephrology dialysis transplantation
Most read
Least read
Bar heights use a square-root scale.
Mint this article as an NFT
Not yet mintedCreate a permanent, verifiable on-chain record of this article on the Scimatic Network. The NFT is held in your Journament account, and you can withdraw it to your own wallet at any time.
5
SUSD
one-off · no wallet required
Abstract
Abstract Diabetic kidney disease (DKD) now has more proven kidney-protective therapies than at any previous time: renin-angiotensin system inhibitors (RASi), sodium-glucose cotransporter-2 (SGLT2) inhibitors, glucagon-like peptide-1 receptor agonists (GLP-1 RAs), and the nonsteroidal mineralocorticoid receptor antagonist (nsMRA) finerenone. However, no head-to-head randomized controlled trial (RCT) has compared these classes, no Phase 3 trial has confirmed that specific multi-class combinations improve hard outcomes beyond well-selected monotherapy; and long-term safety of sustained combination therapy has not been fully characterized. This review synthesizes contemporary evidence for kidney-protective therapy in adults with DKD, emphasizing that non-pharmacologic measures—blood pressure control, individualized glycemic targets, sodium and protein moderation, structured exercise, weight management, and smoking cessation—should be intensified concurrently with drug therapy. We propose an individualization framework that selects agents whose mechanisms address more than one of the patient’s clinical problems simultaneously and avoids those whose adverse effects conflict with active comorbidities. Combination therapy is biologically rational and supported by additive albuminuria reduction (CONFIDENCE) and lifetime modeling, but hard-outcome confirmation is absent. Until such trials are available, the most defensible framework is an individualized, monitoring-based strategy that adapts through addition, hold, or deprescribing based on clinical evolution.
| Reference Key |
openalex_W7201954460
Use this key to autocite in the manuscript while using
SciMatic Manuscript Manager or Thesis Manager
|
|---|---|
| Authors | Zurong Zhang, Li Li, Ming Yang, Wei Chen, Li Xiao, Lin Sun, Rajiv Agarwal |
| Journal | nephrology dialysis transplantation |
| Year | 2026 |
| DOI |
10.1093/ndt/gfag179
|
| URL | |
| Keywords | Keywords not found |
Citations
No citations found. To add a citation, contact the admin at info@scimatic.org
Comments
No comments yet. Be the first to comment on this article.