Novel Management Approaches Diabetic Kidney Disease and Chronic Kidney Disease: A Systematic Review

Abstract

Background: Diabetic Kidney Disease (DKD), a major health concern, leads to renal replacement therapy and increased mortality, primarily due to cardiovascular complications. DKD, a prevalent and progressive condition, affects a significant portion of the global population, estimated at around one in every seven individuals. Despite advances in treatment, a comprehensive understanding of novel biomarkers for DKD progression is essential for effective management. This systematic review aims to integrate emerging research on these biomarkers, considering the complex nature of DKD and the range of therapeutic interventions. Aim: This systematic review aims to integrate and critically evaluate the emerging research on novel biomarkers in the context of DKD progression, considering the multifaceted nature of the disease and the varied therapeutic approaches that have shown renoprotective effects. Methods: Adhering to PRISMA Statement 2020 guidelines, this review includes studies focusing on patients with DKD, evaluating novel biomarkers for disease progression. The search covered PubMed, Embase, and the Cochrane Library, including only Randomised Controlled Trials (RCTs) published in the last five years. A narrative synthesis approach was used for data analysis. Results: Thirteen studies involving various interventions like cholecalciferol, Coenzyme Q10, probiotics, and DPP-4 inhibitors were included. These studies assessed the impact of interventions on biomarkers related to kidney function and disease progression, such as eGFR, albumin-to-creatinine ratio, and various inflammatory markers. Key findings include improvements in angiogenic markers, prognostic value of TNF receptors in CKD progression, and the benefits of treatments on renal and cardiovascular outcomes. Conclusion: This review highlights the importance of novel biomarkers in understanding and managing DKD. The findings suggest that a multifaceted approach, including a panel of biomarkers and omics-based techniques, is essential for a comprehensive understanding of DKD progression. Future research should focus on validating these biomarkers and methodologies for their integration into clinical practice.