Chronic Kidney Disease (CKD) poses a significant healthcare challenge in Saudi Arabia, necessitating a structured approach to management and treatment. Recent consensus guidelines in Saudi Arabia emphasize a comprehensive strategy for CKD management, tailored to local needs and healthcare resources. The guidelines advocate for early detection and stratified care to mitigate the progression of CKD and improve patient outcomes. Key recommendations include the routine assessment of albuminuria and estimated glomerular filtration rate (eGFR) for accurate diagnosis and staging of CKD. The consensus underscores the importance of utilizing updated tools like the CKD-EPI 2021 equation for eGFR calculation and incorporating cystatin C measurements for enhanced diagnostic accuracy. Management strategies focus on controlling underlying conditions such as diabetes and hypertension, which are prevalent risk factors in the Saudi population. Personalized treatment plans are recommended, incorporating lifestyle modifications, pharmacological interventions including SGLT-2 inhibitors and GLP 1 RA, and regular monitoring to manage CKD complications effectively. The guidelines also highlight the need for specialized care and referral pathways for advanced CKD stages, including the role of nephrologists in the comprehensive management of CKD patients. In addition, the consensus addresses the need for improving public awareness and education about CKD, emphasizing early screening and preventive measures, particularly in high-risk groups. The implementation of these guidelines aims to optimize CKD management across Saudi Arabia, reduce the burden of kidney disease, and enhance overall patient care in the region.
References
[1]
Kovesdy, C.P. (2022) Epidemiology of Chronic Kidney Disease: An Update 2022. Kidney International Supplements, 12, 7-11. https://doi.org/10.1016/j.kisu.2021.11.003
[2]
Stevens, P.E., Ahmed, S.B., Carrero, J.J., Foster, B., Francis, A., Hall, R.K., et al. (2024) KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney International, 105, S117-S314. https://doi.org/10.1016/j.kint.2023.10.018
[3]
Johansen, K.L., Chertow, G.M., Foley, R.N., Gilbertson, D.T., Herzog, C.A., Ishani, A., et al. (2021) US Renal Data System 2020 Annual Data Report: Epidemiology of Kidney Disease in the United States. American Journal of Kidney Diseases, 77, A7-A8. https://doi.org/10.1053/j.ajkd.2021.01.002
[4]
de Boer, I.H. (2013) Kidney Disease and Related Findings in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study. Diabetes Care, 37, 24-30. https://doi.org/10.2337/dc13-2113
[5]
de Boer, I.H. (2011) Temporal Trends in the Prevalence of Diabetic Kidney Disease in the United States. Journal of the American Medical Association, 305, 2532-2539. https://doi.org/10.1001/jama.2011.861
[6]
Afkarian, M., Zelnick, L.R., Hall, Y.N., Heagerty, P.J., Tuttle, K., Weiss, N.S., et al. (2016) Clinical Manifestations of Kidney Disease among US Adults with Diabetes, 1988-2014. Journal of the American Medical Association, 316, 602-610. https://doi.org/10.1001/jama.2016.10924
[7]
de Boer, I.H., Khunti, K., Sadusky, T., Tuttle, K.R., Neumiller, J.J., Rhee, C.M., et al. (2022) Diabetes Management in Chronic Kidney Disease: A Consensus Report by the American Diabetes Association (ADA) and Kidney Disease: Improving Global Outcomes (Kdigo). Diabetes Care, 45, 3075-3090. https://doi.org/10.2337/dci22-0027
[8]
Samson, S.L., Vellanki, P., Blonde, L., Christofides, E.A., Galindo, R.J., Hirsch, I.B., et al. (2023) American Association of Clinical Endocrinology Consensus Statement: Comprehensive Type 2 Diabetes Management Algorithm—2023 Update. Endocrine Practice, 29, 305-340. https://doi.org/10.1016/j.eprac.2023.02.001
[9]
Mousa, D., Alharbi, A., Helal, I., Al-homrany, M., Alhujaili, F., Alhweish, A., et al. (2021) Prevalence and Associated Factors of Chronic Kidney Disease among Relatives of Hemodialysis Patients in Saudi Arabia. Kidney International Reports, 6, 817-820. https://doi.org/10.1016/j.ekir.2020.12.029
[10]
Tonelli, M. and Dickinson, J.A. (2020) Early Detection of CKD: Implications for Low-Income, Middle-Income, and High-Income Countries. Journal of the American Society of Nephrology, 31, 1931-1940. https://doi.org/10.1681/ASN.2020030277
[11]
Francis, A., Harhay, M.N., Ong, A.C.M., Tummalapalli, S.L., Ortiz, A., Fogo, A.B., et al. (2024) Chronic Kidney Disease and the Global Public Health Agenda: An International Consensus. Nature Reviews Nephrology, 3, 1-13.
[12]
Dharmarajan, S.H., Bragg-Gresham, J.L., Morgenstern, H., Gillespie, B.W., Li, Y., Powe, N.R., et al. (2017) State-Level Awareness of Chronic Kidney Disease in the U.S. American Journal of Preventive Medicine, 53, 300-307. https://doi.org/10.1016/j.amepre.2017.02.015
[13]
Bikbov, B. (2020) Global, Regional, and National Burden of Chronic Kidney Disease, 1990-2017: A Systematic Analysis for the Global Burden of Disease Study 2017. The Lancet, 395, 709-733.
[14]
Cockwell, P. and Fisher, L. (2020) The Global Burden of Chronic Kidney Disease. The Lancet, 395, 662-664. https://doi.org/10.1016/s0140-6736(19)32977-0
[15]
Farrell, D.R. and Vassalotti, J.A. (2024) Screening, Identifying, and Treating Chronic Kidney Disease: Why, Who, When, How, and What? BMC Nephrology, 25, Article No. 34. https://doi.org/10.1186/s12882-024-03466-5
[16]
Alobaidi, S. (2021) Knowledge of Chronic Kidney Disease among the Population of Saudi Arabia Evaluated Using a Validated Questionnaire: A Cross-Sectional Study. Patient Preference and Adherence, 15, 1281-1288. https://doi.org/10.2147/ppa.s315369
[17]
Mallamaci, F. and Tripepi, G. (2024) Risk Factors of Chronic Kidney Disease Progression: Between Old and New Concepts. Journal of Clinical Medicine, 13, Article 678. https://doi.org/10.3390/jcm13030678
[18]
Levey, A.S., Titan, S.M., Powe, N.R., Coresh, J. and Inker, L.A. (2020) Kidney Disease, Race, and GFR Estimation. Clinical Journal of the American Society of Nephrology, 15, 1203-1212. https://doi.org/10.2215/cjn.12791019
[19]
Vestergaard, S.V., Christiansen, C.F., Thomsen, R.W., Birn, H. and Heide-Jørgensen, U. (2021) Identification of Patients with CKD in Medical Databases. Clinical Journal of the American Society of Nephrology, 16, 543-551. https://doi.org/10.2215/cjn.15691020
[20]
Al-Qahtani, M., Tawhari, I., Alhmare, A.M., Badawi, A.S., Alsalem, A., Gazzan, M.A., Hamdi, A.M., Rashid, A. and Alqahtani, AM. (2024) The Awareness, Prevalence, and Risk Factors of Chronic Kidney Disease Among Diabetes Mellitus and Hypertensive Patients in the Aseer Region, Saudi Arabia. Cureus, 16, e53366. https://doi.org/10.7759/cureus.53366
[21]
Ahmed, H.G., Alzayed, F.S.M., Albluwe, H.K.A., Alosayfir, Z.A.S., Aljarallah, M.Y.J., Alghazi, B.K.M., et al. (2024) Etiology of Chronic Kidney Disease (CKD) in Saudi Arabia. https://www.ijmrhs.com/abstract/etiology-of-chronic-kidney-disease-ckd-in-saudi-arabia-18407.html
Clarke Stout, L., Kumar, S. and Whorton, E.B. (1993) Focal Mesangiolysis and the Pathogenesis of the Kimmelstiel-Wilson Nodule. Human Pathology, 24, 77-89. https://doi.org/10.1016/0046-8177(93)90066-p
[24]
Ahmed, H.G. (2019) Etiology of Chronic Kidney Disease (CKD) in Saudi Arabia. https://pesquisa.bvsalud.org/portal/resource/pt/sea-204935
[25]
Tankeu, A.T., Kaze, F.F., Noubiap, J.J., Chelo, D., Dehayem, M.Y. and Sobngwi, E. (2017) Exercise-induced Albuminuria and Circadian Blood Pressure Abnormalities in Type 2 Diabetes. World Journal of Nephrology, 6, 209-216. https://doi.org/10.5527/wjn.v6.i4.209
[26]
Yarnoff, B.O., Hoerger, T.J., Simpson, S.K., Leib, A., Burrows, N.R., Shrestha, S.S., et al. (2017) The Cost-Effectiveness of Using Chronic Kidney Disease Risk Scores to Screen for Early-Stage Chronic Kidney Disease. BMC Nephrology, 18, Article No. 85. https://doi.org/10.1186/s12882-017-0497-6
[27]
Fox, C.S., Matsushita, K., Woodward, M., Bilo, H.J., Chalmers, J., Heerspink, H.J.L., et al. (2012) Associations of Kidney Disease Measures with Mortality and End-Stage Renal Disease in Individuals with and without Diabetes: A Meta-Analysis. The Lancet, 380, 1662-1673. https://doi.org/10.1016/s0140-6736(12)61350-6
[28]
American Diabetes Association Professional Practice Committee (2023) Chronic Kidney Disease and Risk Management: Standards of Care in Diabetes—2024. Diabetes Care, 47, S219–S230.
[29]
Harambat, J., Kunzmann, K., Azukaitis, K., Bayazit, A.K., Canpolat, N., Doyon, A., et al. (2017) Metabolic Acidosis Is Common and Associates with Disease Progression in Children with Chronic Kidney Disease. Kidney International, 92, 1507-1514. https://doi.org/10.1016/j.kint.2017.05.006
[30]
Fuhrman, D.Y., Schneider, M.F., Dell, K.M., Blydt-Hansen, T.D., Mak, R., Saland, J.M., et al. (2017) Albuminuria, Proteinuria, and Renal Disease Progression in Children with CKD. Clinical Journal of the American Society of Nephrology, 12, 912-920. https://doi.org/10.2215/cjn.11971116
[31]
Vistisen, D., Andersen, G.S., Hulman, A., Persson, F., Rossing, P. and Jørgensen, M.E. (2019) Progressive Decline in Estimated Glomerular Filtration Rate in Patients with Diabetes after Moderate Loss in Kidney Function—Even without Albuminuria. Diabetes Care, 42, 1886-1894. https://doi.org/10.2337/dc19-0349
[32]
Shlipak, M.G., Tummalapalli, S.L., Boulware, L.E., Grams, M.E., Ix, J.H., Jha, V., etal. (2021) The Case for Early Identification and Intervention of Chronic Kidney Disease: Conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference. Kidney International, 99, 34-47.
[33]
Venuthurupalli, S.K., Hoy, W.E., Healy, H.G., Cameron, A. and Fassett, R.G. (2018) CKD Screening and Surveillance in Australia: Past, Present, and Future. Kidney International Reports, 3, 36-46. https://doi.org/10.1016/j.ekir.2017.09.012
[34]
Levin, A., Okpechi, I.G., Caskey, F.J., Yang, C., Tonelli, M. and Jha, V. (2023) Perspectives on Early Detection of Chronic Kidney Disease: The Facts, the Questions, and a Proposed Framework for 2023 and beyond. Kidney International, 103, 1004-1008. https://doi.org/10.1016/j.kint.2023.03.009
[35]
Lameire, N.H., Levin, A., Kellum, J.A., Cheung, M., Jadoul, M., Winkelmayer, W.C., et al. (2021) Harmonizing Acute and Chronic Kidney Disease Definition and Classification: Report of a Kidney Disease: Improving Global Outcomes (KDIGO) Consensus Conference. Kidney International, 100, 516-526. https://doi.org/10.1016/j.kint.2021.06.028
[36]
Cusick, M.M., Tisdale, R.L., Chertow, G.M., Owens, D.K. and Goldhaber-Fiebert, J.D. (2023) Population-Wide Screening for Chronic Kidney Disease. Annals of Internal Medicine, 176, 788-797. https://doi.org/10.7326/m22-3228
[37]
Stanifer, J.W., Von Isenburg, M., Chertow, G.M. and Anand, S. (2018) Chronic Kidney Disease Care Models in Low and Middle-Income Countries: A Systematic Review. BMJ Global Health, 3, e000728. https://doi.org/10.1136/bmjgh-2018-000728
[38]
Bello, A.K., Levin, A., Tonelli, M., Okpechi, I.G., Feehally, J., Harris, D., et al. (2017) Assessment of Global Kidney Health Care Status. Journal of the American Medical Association, 317, 1864-1881. https://doi.org/10.1001/jama.2017.4046
[39]
Nelson, R.G., Grams, M.E., Ballew, S.H., Sang, Y., Azizi, F., Chadban, S.J., et al. (2019) Development of Risk Prediction Equations for Incident Chronic Kidney Disease. Journal of the American Medical Association, 322, 2104-2114. https://doi.org/10.1001/jama.2019.17379
[40]
Nilsson, E., Gasparini, A., Ärnlöv, J., Xu, H., Henriksson, K.M., Coresh, J., et al. (2017) Incidence and Determinants of Hyperkalemia and Hypokalemia in a Large Healthcare System. International Journal of Cardiology, 245, 277-284. https://doi.org/10.1016/j.ijcard.2017.07.035
[41]
Bandak, G., Sang, Y., Gasparini, A., Chang, A.R., Ballew, S.H., Evans, M., et al. (2017) Hyperkalemia after Initiating Renin–Angiotensin System Blockade: The Stockholm Creatinine Measurements (SCREAM) Project. Journal of the American Heart Association, 6, e005428. https://doi.org/10.1161/jaha.116.005428
[42]
Hughes-Austin, J.M., Rifkin, D.E., Beben, T., Katz, R., Sarnak, M.J., Deo, R., et al. (2017) The Relation of Serum Potassium Concentration with Cardiovascular Events and Mortality in Community-Living Individuals. Clinical Journal of the American Society of Nephrology, 12, 245-252. https://doi.org/10.2215/cjn.06290616
[43]
Webster, A.C., Nagler, E.V., Morton, R.L. and Masson, P. (2017) Chronic Kidney Disease. The Lancet, 389, 1238-1252. https://doi.org/10.1016/s0140-6736(16)32064-5
[44]
Lindson, N., Pritchard, G., Hong, B., Fanshawe, T.R., Pipe, A. and Papadakis, S. (2021) Strategies to Improve Smoking Cessation Rates in Primary Care. Cochrane Database of Systematic Reviews, 2021, CD011556. https://doi.org/10.1002/14651858.cd011556.pub2
[45]
Livingstone-Banks, J., Fanshawe, T.R., Thomas, K.H., Theodoulou, A., Hajizadeh, A., Hartman, L., et al. (2023) Nicotine Receptor Partial Agonists for Smoking Cessation. Wiley. https://doi.org/10.1002/14651858.cd006103.pub8
[46]
Kolanu, N.D., Syeda, Z.R., Joshi, N., Singh, P. and Erukulla, M. (2024) The Differential Impact of Medical Therapy and Lifestyle Modification on Cardiovascular Health and Risk of Adverse Cardiovascular Events: A Narrative Review. Cureus, 16, e87742. https://doi.org/10.7759/cureus.57742
[47]
KDIGO (2022) Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease. Kidney International, 102, S1-S127.
[48]
Pollock, C., Moon, J., Ngoc Ha, L.P., Gojaseni, P., Ching, C.H., Gomez, L., et al. (2024) Framework of Guidelines for Management of CKD in Asia. Kidney International Reports, 9, 752-790. https://doi.org/10.1016/j.ekir.2023.12.010
[49]
Misra, A., Jayawardena, R. and Anoop, S. (2019) Obesity in South Asia: Phenotype, Morbidities, and Mitigation. Current Obesity Reports, 8, 43-52. https://doi.org/10.1007/s13679-019-0328-0
[50]
Naderi, N., Kleine, C., Park, C., Hsiung, J., Soohoo, M., Tantisattamo, E., et al. (2018) Obesity Paradox in Advanced Kidney Disease: From Bedside to the Bench. Progress in Cardiovascular Diseases, 61, 168-181. https://doi.org/10.1016/j.pcad.2018.07.001
[51]
Knowler, W.C., Chen, H., Bahnson, J.L., Kahn, S.E., Lewis, C.E., Nathan, D.M., et al. (2024) Within and Post-Trial Effects of an Intensive Lifestyle Intervention on Kidney Disease in Adults with Overweight or Obesity and Type 2 Diabetes Mellitus: A Secondary Analysis of the Look AHEAD Clinical Trial. BMJ Open Diabetes Research &Care, 12, e004079. https://doi.org/10.1136/bmjdrc-2024-004079
[52]
Zhu, P., Herrington, W.G., Haynes, R., Emberson, J., Landray, M.J., Sudlow, C.L.M., et al. (2020) Conventional and Genetic Evidence on the Association between Adiposity and CKD. Journal of the American Society of Nephrology, 32, 127-137. https://doi.org/10.1681/asn.2020050679
[53]
Cosola, C., Rocchetti, M.T., Sabatino, A., Fiaccadori, E., Di Iorio, B.R. and Gesualdo, L. (2018) Microbiota Issue in CKD: How Promising Are Gut-Targeted Approaches? Journal of Nephrology, 32, 27-37. https://doi.org/10.1007/s40620-018-0516-0
[54]
Molina, P., Gavela, E., Vizcaíno, B., Huarte, E. and Carrero, J.J. (2021) Optimizing Diet to Slow CKD Progression. Frontiers in Medicine, 8, Article 654250. https://doi.org/10.3389/fmed.2021.654250
[55]
Adair, K.E. and Bowden, R.G. (2020) Ameliorating Chronic Kidney Disease Using a Whole Food Plant-Based Diet. Nutrients, 12, Article 1007. https://doi.org/10.3390/nu12041007
[56]
Kelly, J.T., Su, G., Zhang, L., Qin, X., Marshall, S., González-Ortiz, A., et al. (2020) Modifiable Lifestyle Factors for Primary Prevention of CKD: A Systematic Review and Meta-Analysis. Journal of the American Society of Nephrology, 32, 239-253. https://doi.org/10.1681/asn.2020030384
[57]
Kelly, J.T., Palmer, S.C., Wai, S.N., Ruospo, M., Carrero, J., Campbell, K.L., et al. (2016) Healthy Dietary Patterns and Risk of Mortality and ESRD in CKD: A Meta-Analysis of Cohort Studies. Clinical Journal of the American Society of Nephrology, 12, 272-279. https://doi.org/10.2215/cjn.06190616
[58]
Hippisley-Cox, J., Coupland, C. and Brindle, P. (2017) Development and Validation of QRISK3 Risk Prediction Algorithms to Estimate Future Risk of Cardiovascular Disease: Prospective Cohort Study. British Medical Journal, 357, j2099. https://doi.org/10.1136/bmj.j2099
[59]
Murray, D.P., Young, L., Waller, J., Wright, S., Colombo, R., Baer, S., et al. (2018) Is Dietary Protein Intake Predictive of 1-Year Mortality in Dialysis Patients? The American Journal of the Medical Sciences, 356, 234-243. https://doi.org/10.1016/j.amjms.2018.06.010
[60]
Cheung, A.K., Whelton, P.K., Muntner, P., Schutte, A.E., Moran, A.E., Williams, B., et al. (2023) International Consensus on Standardized Clinic Blood Pressure Measurement—A Call to Action. The American Journal of Medicine, 136, 438-445.e1. https://doi.org/10.1016/j.amjmed.2022.12.015
[61]
Nazarzadeh, M., Bidel, Z., Canoy, D., Copland, E., Bennett, D.A., Dehghan, A., et al. (2022) Blood Pressure-Lowering Treatment for Prevention of Major Cardiovascular Diseases in People with and without Type 2 Diabetes: An Individual Participant-Level Data Meta-Analysis. TheLancet Diabetes Endocrinol, 10, 645-654.
[62]
Cheung, A.K., Chang, T.I., Cushman, W.C., Furth, S.L., Hou, F.F., Ix, J.H., et al. (2021) KDIGO 2021 Clinical Practice Guideline for the Management of Blood Pressure in Chronic Kidney Disease. Kidney International, 99, S1-S87. https://doi.org/10.1016/j.kint.2020.11.003
[63]
Chen, T.K., Hoenig, M.P., Nitsch, D. and Grams, M.E. (2023) Advances in the Management of Chronic Kidney Disease. British Medical Journal, 383, e074216. https://doi.org/10.1136/bmj-2022-074216
[64]
Heerspink, H.J.L., Stefánsson, B.V., Correa-Rotter, R., Chertow, G.M., Greene, T., Hou, F., et al. (2020) Dapagliflozin in Patients with Chronic Kidney Disease. New England Journal of Medicine, 383, 1436-1446. https://doi.org/10.1056/nejmoa2024816
[65]
Perkovic, V., Jardine, M.J., Neal, B., Bompoint, S., Heerspink, H.J.L., Charytan, D.M., et al. (2019) Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy. New England Journal of Medicine, 380, 2295-2306. https://doi.org/10.1056/nejmoa1811744
[66]
Perkovic, V., de Zeeuw, D., Mahaffey, K.W., Fulcher, G., Erondu, N., Shaw, W., et al. (2018) Canagliflozin and Renal Outcomes in Type 2 Diabetes: Results from the CANVAS Program Randomized Clinical Trials. The Lancet Diabetes & Endocrinology, 6, 691-704. https://doi.org/10.1016/s2213-8587(18)30141-4
[67]
Neal, B., Perkovic, V., et al. (2024) Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes. The New England Journal of Medicine, 377, 644-657. https://pubmed.ncbi.nlm.nih.gov/28605608/?dopt=Abstract
[68]
The EMPA-KIDNEY Collaborative Group, Herrington, W.G., Staplin, N., Wanner, C., Green, J.B., Hauske, S.J., et al. (2023) Empagliflozin in Patients with Chronic Kidney Disease. New England Journal of Medicine, 388, 117-127. https://doi.org/10.1056/nejmoa2204233
[69]
Wheeler, D.C., Toto, R.D., Stefánsson, B.V., Jongs, N., Chertow, G.M., Greene, T., et al. (2021) A Pre-Specified Analysis of the DAPA-CKD Trial Demonstrates the Effects of Dapagliflozin on Major Adverse Kidney Events in Patients with IgA Nephropathy. Kidney International, 100, 215-224. https://doi.org/10.1016/j.kint.2021.03.033
[70]
Wheeler, D.C., Jongs, N., Stefansson, B.V., Chertow, G.M., Greene, T., Hou, F.F., et al. (2021) Safety and Efficacy of Dapagliflozin in Patients with Focal Segmental Glomerulosclerosis: A Prespecified Analysis of the Dapagliflozin and Prevention of Adverse Outcomes in Chronic Kidney Disease (DAPA-CKD) Trial. Nephrology Dialysis Transplantation, 37, 1647-1656. https://doi.org/10.1093/ndt/gfab335
[71]
DeFronzo, R.A., Reeves, W.B. and Awad, A.S. (2021) Pathophysiology of Diabetic Kidney Disease: Impact of SGLT2 Inhibitors. Nature Reviews Nephrology, 17, 319-334. https://doi.org/10.1038/s41581-021-00393-8
[72]
Navaneethan, S.D., Nigwekar, S.U., Sehgal, A.R. and Strippoli, G.F.M. (2009) Aldosterone Antagonists for Preventing the Progression of Chronic Kidney Disease. Clinical Journal of the American Society of Nephrology, 4, 542-551. https://doi.org/10.2215/cjn.04750908
[73]
Agarwal, R., Filippatos, G., Pitt, B., Anker, S.D., Rossing, P., Joseph, A., et al. (2021) Cardiovascular and Kidney Outcomes with Finerenone in Patients with Type 2 Diabetes and Chronic Kidney Disease: The FIDELITY Pooled Analysis. European Heart Journal, 43, 474-484. https://doi.org/10.1093/eurheartj/ehab777
[74]
Pitt, B., Filippatos, G., Agarwal, R., Anker, S.D., Bakris, G.L., Rossing, P., et al. (2021) Cardiovascular Events with Finerenone in Kidney Disease and Type 2 Diabetes. New England Journal of Medicine, 385, 2252-2263. https://doi.org/10.1056/nejmoa2110956
[75]
Barrera-Chimal, J., Lima-Posada, I., Bakris, G.L. and Jaisser, F. (2021) Mineralocorticoid Receptor Antagonists in Diabetic Kidney Disease—Mechanistic and Therapeutic Effects. Nature Reviews Nephrology, 18, 56-70. https://doi.org/10.1038/s41581-021-00490-8
[76]
Bakris, G.L., Agarwal, R., Anker, S.D., Pitt, B., Ruilope, L.M., Rossing, P., et al. (2020) Effect of Finerenone on Chronic Kidney Disease Outcomes in Type 2 Diabetes. New England Journal of Medicine, 383, 2219-2229. https://doi.org/10.1056/nejmoa2025845
[77]
Epstein, M., Kovesdy, C.P., Clase, C.M., Sood, M.M. and Pecoits-Filho, R. (2022) Aldosterone, Mineralocorticoid Receptor Activation, and CKD: A Review of Evolving Treatment Paradigms. American Journal of Kidney Diseases, 80, 658-666. https://doi.org/10.1053/j.ajkd.2022.04.016
[78]
Gerstein, H.C., Sattar, N., Rosenstock, J., Ramasundarahettige, C., Pratley, R., Lopes, R.D., et al. (2021) Cardiovascular and Renal Outcomes with Efpeglenatide in Type 2 Diabetes. New England Journal of Medicine, 385, 896-907. https://doi.org/10.1056/nejmoa2108269
[79]
Bethel, M.A., Mentz, R.J., Merrill, P., Buse, J.B., Chan, J.C., Goodman, S.G., et al. (2019) Microvascular and Cardiovascular Outcomes According to Renal Function in Patients Treated with Once-Weekly Exenatide: Insights from the EXSCEL Trial. Diabetes Care, 43, 446-452. https://doi.org/10.2337/dc19-1065
[80]
Gerstein, H.C., Colhoun, H.M., Dagenais, G.R., Diaz, R., Lakshmanan, M., Pais, P., et al. (2017) Design and Baseline Characteristics of Participants in the Researching Cardiovascular Events with a Weekly Incretin in Diabetes (Rewind) Trial on the Cardiovascular Effects of Dulaglutide. Diabetes, Obesity and Metabolism, 20, 42-49. https://doi.org/10.1111/dom.13028
[81]
Gerstein, H.C., Colhoun, H.M., Dagenais, G.R., Diaz, R., Lakshmanan, M., Pais, P., et al. (2019) Dulaglutide and Cardiovascular Outcomes in Type 2 Diabetes (REWIND): A Double-Blind, Randomized Placebo-Controlled Trial. The Lancet, 394, 121-130.
[82]
Holman, R.R., Bethel, M.A., Mentz, R.J., Thompson, V.P., Lokhnygina, Y., Buse, J.B., et al. (2017) Effects of Once-Weekly Exenatide on Cardiovascular Outcomes in Type 2 Diabetes. New England Journal of Medicine, 377, 1228-1239. https://doi.org/10.1056/nejmoa1612917
[83]
Marso, S.P., Bain, S.C., Consoli, A., Eliaschewitz, F.G., Jódar, E., Leiter, L.A., et al. (2016) Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes. New England Journal of Medicine, 375, 1834-1844. https://doi.org/10.1056/nejmoa1607141
[84]
Marso, S.P., Daniels, G.H., Brown-Frandsen, K., Kristensen, P., Mann, J.F.E., Nauck, M.A., et al. (2016) Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes. New England Journal of Medicine, 375, 311-322. https://doi.org/10.1056/nejmoa1603827
[85]
Mann, J.F.E., Ørsted, D.D., Brown-Frandsen, K., Marso, S.P., Poulter, N.R., Rasmussen, S., et al. (2017) Liraglutide and Renal Outcomes in Type 2 Diabetes. New England Journal of Medicine, 377, 839-848. https://doi.org/10.1056/nejmoa1616011
[86]
Bentley-Lewis, R., Aguilar, D., Riddle, M.C., Claggett, B., Diaz, R., Dickstein, K., et al. (2015) Rationale, Design, and Baseline Characteristics in Evaluation of Lixisenatide in Acute Coronary Syndrome, a Long-Term Cardiovascular End Point Trial of Lixisenatide versus Placebo. American Heart Journal, 169, 631-638.e7. https://doi.org/10.1016/j.ahj.2015.02.002
[87]
Pfeffer, M.A., Claggett, B., Diaz, R., Dickstein, K., Gerstein, H.C., Køber, L.V., et al. (2015) Lixisenatide in Patients with Type 2 Diabetes and Acute Coronary Syndrome. New England Journal of Medicine, 373, 2247-2257. https://doi.org/10.1056/nejmoa1509225
[88]
Muskiet, M.H.A., Tonneijck, L., Huang, Y., Liu, M., Saremi, A., Heerspink, H.J.L., et al. (2018) Lixisenatide and Renal Outcomes in Patients with Type 2 Diabetes and Acute Coronary Syndrome: An Exploratory Analysis of the ELIXA Randomized, Placebo-Controlled Trial. The Lancet Diabetes & Endocrinology, 6, 859-869. https://doi.org/10.1016/s2213-8587(18)30268-7
[89]
Sattar, N., Lee, M.M.Y., Kristensen, S.L., Branch, K.R.H., Del Prato, S., Khurmi, N.S., et al. (2021) Cardiovascular, Mortality, and Kidney Outcomes with GLP-1 Receptor Agonists in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Trials. The Lancet Diabetes & Endocrinology, 9, 653-662. https://doi.org/10.1016/s2213-8587(21)00203-5
[90]
Tuttle, K.R., Lakshmanan, M.C., Rayner, B., Busch, R.S., Zimmermann, A.G., Woodward, D.B., et al. (2018) Dulaglutide versus Insulin Glargine in Patients with Type 2 Diabetes and Moderate-to-Severe Chronic Kidney Disease (AWARD-7): A Multicentre, Open-Label, Randomised Trial. The Lancet Diabetes & Endocrinology, 6, 605-617. https://doi.org/10.1016/s2213-8587(18)30104-9
[91]
Perkovic, V., Tuttle, K.R., Rossing, P., Mahaffey, K.W., Mann, J.F.E., Bakris, G., et al. (2024) Effects of Semaglutide on Chronic Kidney Disease in Patients with Type 2 Diabetes. New England Journal of Medicine, 391, 109-121. https://doi.org/10.1056/nejmoa2403347
[92]
Alsheikh, A., Alshehri, A., Alzahrani, S., AlJammah, A., Alqahtani, F., Alotaibi, M., et al. (2024) Oral Semaglutide Effectiveness and Safety in Real World Practice; The Revolution Study. Diabetes Epidemiology and Management, 14, Article 100209. https://doi.org/10.1016/j.deman.2024.100209
[93]
Alsheikh, A., Alshehri, A., Alzahrani, S., Jammah, A.A., Alqahtani, F., Alotaibi, M., et al. (2023) Evaluating the Clinical Effectiveness and Safety of Semaglutide in Individuals with Uncontrolled Type 2 Diabetes. Real-World Evidence from Saudi Arabia: The Observational, Multicenter, 15-Month Evolution Study. Diabetes Therapy, 15, 473-485. https://doi.org/10.1007/s13300-023-01516-z
[94]
O'Neil, P.M., Birkenfeld, A.L., McGowan, B., Mosenzon, O., Pedersen, S.D., Wharton, S., et al. (2018) Efficacy and Safety of Semaglutide Compared with Liraglutide and Placebo for Weight Loss in Patients with Obesity: A Randomized, Double-Blind, Placebo and Active Controlled, Dose-Ranging, Phase 2 Trial. The Lancet, 392, 637-649. https://doi.org/10.1016/s0140-6736(18)31773-2
[95]
Dieter, B.P., Alicic, R.Z. and Tuttle, K.R. (2018) GLP-1 Receptor Agonists in Diabetic Kidney Disease: From the Patient-Side to the Bench-Side. American Journal of Physiology-Renal Physiology, 315, F1519-F1525. https://doi.org/10.1152/ajprenal.00211.2018
[96]
Smart, N.A., Dieberg, G., Ladhani, M. and Titus, T. (2014) Early Referral to Specialist Nephrology Services for Preventing the Progression to End-Stage Kidney Disease. Cochrane Database of Systematic Reviews, 6, CD007333. https://doi.org/10.1002/14651858.cd007333.pub2
[97]
Ben Salah, G., Farooqui, M., Salem Alshammari, M., Elghazali, A., Kassem, L., Ibrahim, N., et al. (2023) Prevalence, Types and Disclosure of Complementary and Alternative Medicine (CAM) Use among Chronic Kidney Disease (CKD) Patients in Saudi Arabia. Journal of Pharmaceutical Policy and Practice, 16, Article 89. https://doi.org/10.1186/s40545-023-00589-2
[98]
Alhamad, M.A., Almulhim, M.Y., Alburayh, A.A., Alsaad, R.A., Alhajji, A.M., Alnajjar, J.S., et al. (2023) Factors Affecting Adherence to Hemodialysis Therapy among Patients with End-Stage Renal Disease Attending In-Center Hemodialysis in Al-Ahsa Region, Saudi Arabia. Cureus, 15, e46701.