Mechanism of Action of GLP-1 Receptor Agonists
They exert renal and cardiovascular benefits in many patients with diabetic kidney disease (DKD).
Contraindications of GLP-1 Receptor Agonists
GLP-1 receptor agonists should be avoided in patients with a history of pancreatitis, a personal or family history of medullary thyroid carcinoma, or a personal or family history of multiple endocrine neoplasia.They should be used with caution in patients with gastroparesis or underweight patients.
Usage of GLP-1 Receptor Agonists
Semaglutide injection is the preferred GLP-1 receptor agonist for DKD patients.It is the only GLP-1 receptor agonist shown to prevent renal outcomes (loss of kidney function and renal failure), cardiovascular events (myocardial infarction, stroke, and cardiovascular death), and all-cause mortality in this population.
For patients with type 2 diabetes and chronic kidney disease (CKD):
Dose: 1 mg subcutaneously once weekly.
Titration: Starting dose is 0.25 mg. Increase by 0.25 mg every 2–4 weeks based on gastrointestinal tolerance until reaching the full 1 mg dose.
If the 1 mg dose cannot be tolerated due to adverse reactions (e.g., gastrointestinal side effects), continue at the highest tolerated dose.
Dose adjustment is generally not required for low eGFR.
Higher doses may be used if needed to achieve glycemic and weight targets.
Note: The above is an introduction to medications related to diabetic kidney disease, provided for reference only before formal treatment of diabetic kidney disease.Given the complexity of diabetic kidney disease, please receive treatment at a hospital and use medications rationally under the guidance of a doctor.