Review
Version 1
Preserved in Portico This version is not peer-reviewed
Chronic Kidney Disease in the Elderly Patient with Diabetes
Version 1
: Received: 9 October 2023 / Approved: 9 October 2023 / Online: 9 October 2023 (16:56:30 CEST)
A peer-reviewed article of this Preprint also exists.
Ravender, R.; Roumelioti, M.-E.; Schmidt, D.W.; Unruh, M.L.; Argyropoulos, C. Chronic Kidney Disease in the Older Adult Patient with Diabetes. J. Clin. Med. 2024, 13, 348. Ravender, R.; Roumelioti, M.-E.; Schmidt, D.W.; Unruh, M.L.; Argyropoulos, C. Chronic Kidney Disease in the Older Adult Patient with Diabetes. J. Clin. Med. 2024, 13, 348.
Abstract
Diabetes mellitus (DM) and chronic kidney disease (CKD) are common in middle aged and elderly individuals. DM may accelerate the aging process, and the age-related declines in the estimated Glomerular Filtration Rate (eGFR), can pose a challenge to diagnose diabetic kidney disease (DKD) using standard diagnostic criteria especially with absence of severe albuminuria among the elderly. In the presence of CKD and DM, elderly patients may need multidisciplinary care due to susceptibility to various health issues e.g., cognitive decline, auditory or visual impairment, various comorbidities, complex medical regimens, and increased sensitivity to medication adverse effects. As a result, it can be challenging to apply recent therapeutic advancements for the general population to the elderly. We review the evidence that the benefits from these newer therapies apply equally to elderly and non-elderly patients and propose a framework for the management of DKD by discussing the nonpharmacological measures and pharmacological management with renin angiotensin system inhibitors (RASi), Sodium Glucose Co-Transporter two inhibitors (SGLT2i), non-steroidal mineralocorticoids receptor antagonists (MRAs), and Glucagon Like Peptide 1 Receptor Agonists (GLP1-RAs).
Keywords
Diabetes; Chronic Kidney Disease; Treatment; Elderly; Geriatric; Dialysis; SGLT2 inhibitors; GLP1 Receptor Agonists; Non-steroidal Mineralocorticoid Antagonists
Subject
Medicine and Pharmacology, Other
Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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