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DOI: 10.1055/a-1557-3924
Blutdrucksenkende pleiotrope Effekte antidiabetischer Medikamente
Nephroprotektion durch SGLT-2-Inhibitoren, Mineralokortikoid-Rezeptor-Antagonisten und Co.ZUSAMMENFASSUNG
In den letzten Jahren haben sich einige Medikamente hervorgetan, die unabhängig von ihrer primären Indikation einen protektiven Effekt auf die Nierenfunktion ausüben können. Für Nephrologen besonders interessant ist dabei der nephroprotektive Effekt, den die Inhibitoren des Natrium Glukose Kotransporters 2 (SGLT-2: „sodium glucose linked transporter 2“) wie Empagliflozin, Canagliflozin und Dapagliflozin ausüben, unabhängig von ihrem Einfluss auf den Blutzucker und wie wir seit der Studie DAPA-CKD wissen – sogar bei Patienten ohne Diabetes mellitus. Auch die modernen, nichtsteroidalen Mineralokortikoid-Rezeptor-Antagonisten wie Finerenon und Esaxerenon machten hinsichtlich ihrer Nephroprotektion auf sich aufmerksam, unabhängig von ihrer primären Indikation für die Therapie der Herzinsuffizienz und bisweilen der arteriellen Hypertonie. Ursächlich sind hierfür pharmakologische „Mehrfachwirkungen“, die pleiotrope Effekte genannt werden und einen vielschichten Eingriff in die (Patho-)Physiologie des Organismus ermöglichen. Die Therapie der arteriellen Hypertonie erfordert eine synergistische Kombination und stellt einen Angelpunkt in der kardiorenalen Achse dar. Deshalb sollen an diesem Beispiel die pleiotropen Effekte von SGLT-2-Inhibitoren, Mineralokortikoid-Rezeptor-Antagonisten und GLP-1-Agonisten (GLP-1: „glucagon-like peptide 1“) sowie deren klinische Implikationen beleuchtet werden.
Publication History
Article published online:
16 November 2021
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