Abstract

A REVIEW ON EMERGING NOVEL THERAPEUTIC STRATEGIES FOR CHRONIC KIDNEY DISEASE ASSOCIATED WITH CO-MORBIDITIES

C. Denilah Pauline*, S. Divya and Dr. K. Ponnudurai

ABSTRACT

Chronic kidney disease is defined as persistent damage to the kidneys. It is a stage where the kidneys are not functioning properly which can be identified through an estimated GFR by reduction of less than 60 mL/min per 1.73 m². Chronic kidney disease is divided into five different phases under the basis of eGFR. Studies suggest that using single therapy (ARB or ACE) can lead to similar reductions in proteinuria with microalbuminuria patients. Sodium-glucose transport (SGLT) inhibition and Dipeptidyl peptidase (DPP-IV) inhibitors are novel targets to achieve glycemic control for patients with CKD. The best therapeutic option for promising a single combination pill may be DPP-4 and SGLT2 inhibitors. The therapy for present condition of CKD with anaemia may exhibit the quality of life and reduce the need for blood transfusion by using appropriate erythropoietin. The target haemoglobin level ranges between 11.0 and 12.0 g/dL to correct the CKD patients with anaemia. CKD patients often receive insufficient vitamin D due to dietary restrictions and reduced sun exposure. There is an interlink between vitamin D deficiency and decreased estimated GFR. Given the relationship between CVD and CKD progression, uric acid levels may also be one of the challenges for renal injury progression. Allopurinol or febuxostat under the class of Xanthine Oxidase Inhibitors are the preferred medications for lowering uric acid levels. Endothelin receptor antagonist (ERA) may improve kidney injury and fibrosis through various mechanisms. Avosentan (SPP301) is a once-daily, oral and new  CKD patients with anaemia. CKD patients often receive insufficient vitamin D due to dietary restrictions and reduced sun exposure. There is an interlink between vitamin D deficiency and decreased estimated GFR. Given the relationship between CVD and CKD progression, uric acid levels may also be one of the challenges for renal injury progression. Allopurinol or febuxostat under the class of Xanthine Oxidase Inhibitors are the preferred medications for lowering uric acid levels. Endothelin receptor antagonist (ERA) may improve kidney injury and fibrosis through various mechanisms. Avosentan (SPP301) is a once-daily, oral and new 

Keywords: Chronic Kidney Disease, proteinuria, estimated Glomerular filtration rate, NSAIDs.