{"id":"1c84a3a24334","type":"article","url":"https://hartvaat.nl/2026/09/01/sglt2-remmers-glp-1-agonisten-en-finerenone-voor-nierbescherming-bij-type-1-diab/","title":"SGLT2-remmers, GLP-1-agonisten en finerenone voor nierbescherming bij type 1-diabetes","title_en":"Sodium-Glucose Cotransporter-Inhibitors, Incretin Receptor Agonists (Glucagon-Like Peptide-1 Receptor Agonists and Dual Glucose-Dependent Insulinotropic Polypeptide/Glucagon-Like Peptide-1 Receptor Agonists), and Finerenone for Kidney Protection in Type 1 Diabetes.","category":"chronische nierziekte","category_label":"Nierziekte","professions":["cardioloog","internist"],"tags":[],"journal":"Endocrinology and metabolism clinics of North America","doi":"10.1016/j.ecl.2026.04.015","source_url":"https://doi.org/10.1016/j.ecl.2026.04.015","authors":["Michael S Hughes","Francisco J Pasquel"],"significance":5,"published":"2026-08-07","source_date":"2026-09-01","image":"","kennis":["https://hartvaat.nl/kennis/cardiometabool/esc-richtlijn-diabetes-cvd-cardiometabool/","https://hartvaat.nl/kennis/nierziekte/sglt2-nierbescherming-mechanisme/"],"congress":"","summary_en":"This narrative review outlines the pathophysiology of diabetic kidney disease in type 1 diabetes and evaluates the emerging evidence for adjunctive kidney-protective agents, including SGLT2 inhibitors, GLP-1 receptor agonists, and finerenone. While large-scale outcome trials specific to type 1 diabetes are still maturing, current mechanistic data and early clinical findings support their potential role in mitigating hyperfiltration and inflammatory injury. Clinicians should anticipate a shift toward integrating these cardiorenal therapies into standard management protocols for type 1 diabetes as evidence continues to accumulate.","created":"2026-08-01T00:45:35Z","updated":"2026-08-10T10:36:47Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Deze review schetst de pathofysiologie van diabetesgerelateerde nierziekte bij type 1-diabetes en bespreekt het biologische rationale voor nierbeschermende therapieën zoals SGLT2-remmers, GLP-1-receptoragonisten en finerenone. Hoewel het bewijs nog in opkomst is, ondersteunen de huidige mechanistische inzichten en vroege klinische data de integratie van deze middelen in het toekomstige behandeladvies. Voor klinici betekent dit een verschuiving van puur glycemiemanagement naar gerichte cardiorenale bescherming bij deze patiëntengroep.","abstract_original":"Diabetes-related kidney disease (DKD) is a major complication of type 1 diabetes (T1D) and remains a leading cause of kidney failure and cardiovascular risk. In this article, we summarize the biologic rationale and emerging clinical evidence for adjunctive kidney-protective therapies in T1D. We frame DKD pathophysiology in T1D around 3 interrelated domains: hyperglycemia-driven kidney stress, maladaptive tubular-glomerular hemodynamics and hyperfiltration, and inflammatory and fibrotic injury amplified by mineralocorticoid receptor signaling. The rapid growth in mechanistic understanding, clinical trial evidence, and early translation to T1D supports the incorporation of adjunctive kidney-protective therapies into the future management of DKD in T1D."}