Cited by 9Chronic Kidney Disease and DiabetesDiabetes Management and ResearchAcute Kidney Injury Research

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Advancing kidney protection in type 1 diabetes: insights from emerging therapies in type 2 diabetes and chronic kidney disease

Kugathasan, Luxcia, Aronson, Yarden, Sridhar, Vikas S., Ni, Huajing, Ouimet, Jean-Philippe, Limonte, Christine P., Sarma, Shohinee, Cherney, David Z. I.·2025·Expert Review of Clinical Immunology

DOI 10.1080/1744666x.2025.2537446

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Abstract

Introduction For decades, the first-line treatment for kidney protection in people with type 1 diabetes (T1D) and chronic kidney disease (CKD) has been limited to intensive glycemic control, renin-angiotensin system blockers and managing modifiable risk factors. Accordingly, risk of CKD progression has remained unacceptably high, emphasizing the need for novel kidney protective therapies in T1D. Areas covered This review summarizes the recent evidence supporting the use of existing treatments used for kidney protection in people with type 2 diabetes (T2D) for potential repurposing for people with T1D. First, we highlight the putative structural and functional changes that actively contribute to CKD progression and highlight key hemodynamic, pro-inflammatory, and kidney injury risk markers in T1D. Next, we discuss emerging nephroprotective therapies targeting these pathophysiological factors, review mechanistic studies that have assessed kidney benefits of these agents in T1D, and highlight ongoing kidney-focused trials in T1D, including SUGARNSALT (NCT06217302), FINE-ONE (NCT05901831) and REMODEL-T1D (NCT05822609). Expert opinion Several medications have become available that could potentially transform CKD care in T1D. It is essential to devise strategies that could address the treatment landscape for kidney protection in T1D by assessing the risk-benefit calculus and expanding the nephrologist's toolkit for minimizing kidney risk in T1D.

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Influential
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10.1016/j.jdiacomp.2021.107880 · DOI

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Authors: Kugathasan, L., Aronson, Y., Sridhar, V. S., Ni, H., Ouimet, J.-P., Limonte, C. P., Sarma, S., & Cherney, D. Z. I.
Affiliations: University Health Network (CA)
McGill University (CA)
University of Washington (US)
University of Toronto (CA)
Corresponding author: Cherney, David Z. I.
ORCID: Kugathasan, Luxcia
Sridhar, Vikas S.
Ni, Huajing
Limonte, Christine P.
Sarma, Shohinee
Cherney, David Z. I.
Venue: Expert Review of Clinical Immunology
Publisher: Informa UK Limited
Published: 2025-07-24
Volume: 21
Issue: 8
Pages: 1113-1134
ISSN: 1744-666X (ISSN-L)
1744-8409
DOI: 10.1080/1744666x.2025.2537446
OpenAlex: W4412557969
Cited by: 9
References: 220
Citations by year: 2026: 8 · 2025: 1
FWCI: 1.31
Type: journal article
Language: en
Open access: closed
Locations: Expert Review of Clinical Immunology (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Health Sciences › Medicine › Nephrology › Acute Kidney Injury Research
Keywords: type 1 diabetes, chronic kidney disease, renal protection, nephroprotective therapy, drug repurposing, type 2 diabetes, chronic kidney disease progression, renin-angiotensin system inhibitors, inflammation, hemodynamics
MeSH terms: Animals, Clinical Trials as Topic, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Diabetic Nephropathies, Humans, Hypoglycemic Agents, Kidney, Disease Progression, Renal Insufficiency, Chronic

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Advancing kidney protection in type 1 diabetes: insights from emerging therapies in type 2 diabetes and chronic kidney disease

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