Dtsch Med Wochenschr 2021; 146(05): 317-322
DOI: 10.1055/a-1235-0533
Dossier

Die Niere als Schrittmacher kardiovaskulärer Alterung

Kidney as pacemaker for cardiovascular aging
Christoph Wanner
,
Jan Galle
,
Kai Lopau

Nierenkranke altern schneller und vaskuläre Risikofaktoren verstärken den Prozess. SGLT2-Inhibitoren spielen eine signifikante Rolle im Erhalt der Organfunktion, und auch in den Leitlinien werden diese bei diabetischer Nierenerkrankung priorisiert. Auch die Therapie der Herzinsuffizienz wird diesbezüglich neu überdacht. Wie die Prävention interdisziplinär gelingen kann, zeigt der folgende Beitrag.

Abstract

Kidney patients age faster and vascular risk factors intensify the process. Lifetime is reduced up to 16 years in patients with diabetes mellitus type 2 and kidney disease. SGLT2 inhibitors play a significant role in maintaining organ function. By inhibiting the SGLT2 transporter in the proximal tubule of the kidneys, energy and water are continuously excreted and metabolic processes that are counter-regulated are set in motion. This hypometabolic adaptation supports organ functions and induces longevity. Kidney protection extends life expectancy of patients with diabetes mellitus type 2.

Also patients with heart failure benefit and a 3-stage therapy is newly being discussed. The beta blocker is combined with an SGLT2 inhibitor in the first stage. In the second stage, the angiotensin receptor/neprilysin inhibitor and then a mineralocorticoid receptor antagonist (MRA) is used. These therapies have a complementary effect.



Publication History

Publication Date:
01 March 2021 (online)

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