Novel therapeutic approaches in the management of chronic kidney disease: a narrative review

ABSTRACT

Chronic kidney disease (CKD) remains a pathologic entity with constantly rising incidence and high rates of morbidity and mortality, which are associated with serious cardiovascular complications. Moreover, the incidence of end-stage renal disease tends to increase. The epidemiological trends of CKD warrant the development of novel therapeutic approaches aiming to prevent its development or retard its progression through the control of major risk factors: type 2 diabetes mellitus, arterial hypertension, and dyslipidemia. Contemporary therapeutics such as sodium-glucose cotransporter-2 inhibitors and second-generation mineralocorticoid receptor antagonists are utilized in this direction. Additionally, experimental and clinical studies present novel drug categories that could be employed in managing CKD, such as aldosterone synthesis inhibitors or activators guanylate cyclase, while the role of melatonin should be further tested in the clinical setting. Finally, in this patient population, the use of hypolipidemic agents may provide incremental benefits.

KEYWORDS:

• chronic kidney disease
• arterial hypertension
• sodium-glucose cotransporter
• aldosterone
• melatonin
• guanylate cyclase
• dyslipidemia

Declaration of financial/other relationships

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contribution statement

Panagiotis Theofilis performed the literature review and drafted the manuscript. Aikaterini Vordoni performed the literature review and drafted the manuscript. Rigas G Kalaitzidis supervised the work and contributed to the manuscript drafting and editing. All authors read and approved the final version of the manuscript.

Additional information

Funding

This paper was not funded.