Evidence map›Paper›PMID 41528949›Full record

ReviewCardiorenal medicine2026

Therapeutic Advances in Diabetic Kidney Disease: 30 Years of Evidence and the Rise of the "Fantastic Four" in Nephrology.

Faeq Husain-Syed, Goekhan Yuecel, Clara Daschner, Jan Jochims, Babak Yazdani

Abstract readReview
In one paragraph

Review in Cardiorenal medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Mogroside V Alleviates Renal Injury in Diabetic Mice via Regulation of theInternational journal of molecular sciences · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Faeq Husain-SyedDepartment of Medicine II, University Hospital Giessen and Marburg, Justus-Liebig-University Giessen, Giessen, Germany.
Goekhan YuecelFirst Department of Medicine, Faculty of Medicine of the University of Heidelberg, University Medical Center Mannheim, Mannheim, Germany.
Clara DaschnerNephrologisches MVZ Mannheim, ze:ro Praxen, Mannheim, Germany.
Jan JochimsFifth Department of Medicine (Nephrology, Hypertensiology, Rheumatology, Endocrinology, Pneumology), University Medical Center Mannheim, Faculty of Medicine of the University of Heidelberg, Mannheim, Germany.
Babak YazdaniFifth Department of Medicine (Nephrology, Hypertensiology, Rheumatology, Endocrinology, Pneumology), University Medical Center Mannheim, Faculty of Medicine of the University of Heidelberg, Mannheim, Germany, babak.yazdani@umm.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDiabetic kidney disease (DKD) remains the leading cause of chronic kidney disease and kidney failure worldwide. Over the past 3 decades, management has evolved from strict glycemic and blood pressure control to targeted therapies that modify disease progression. SUMMARY: The DCCT/EDIC (1993) confirmed the impact of intensive glycemic and multifactorial risk factor management. But the early 1990s established the foundation of nephroprotective therapy with the Captopril Trial (1993) in type 1 diabetes and subsequent IRMA-1 (2001), IDNT (2001), and the RENAAL (2001) studies established renin-angiotensin-system blockade as the first disease-specific therapy. More than a decade later, sodium-glucose cotransporter-2 (SGLT2) inhibitors transformed care, with EMPA-REG OUTCOME (2015) and CANVAS (2017) studies first demonstrating kidney benefits as secondary outcomes, which were confirmed in subsequent dedicated kidney trials: CREDENCE (2019), DAPA-CKD (2020), and EMPA-KIDNEY (2022) studies, demonstrating consistent reductions in kidney failure and cardiovascular mortality. Finerenone further advanced outcomes in FIDELIO-DKD (2020) and FIGARO-DKD (2021), and combination therapy with SGLT2 inhibition showed additive benefit in the CONFIDENCE (2025) study. Most recently, the FLOW (2024) trial confirmed glucagon-like peptide-1 receptor agonists (GLP-1 RAs) as promising fourth pillar of nephroprotective therapies. KEY MESSAGES: Together, these advances, termed the "Fantastic Four," have redefined standards of care in DKD. This review synthesizes pivotal clinical trials and highlights evolving strategies to guide individualized treatment and future research.

Indexed as

Diabetic NephropathiesNephrologyAngiotensin-Converting Enzyme InhibitorsHumansRenin-Angiotensin SystemSodium-Glucose Transporter 2 InhibitorsAngiotensin-Converting Enzyme InhibitorsSodium-Glucose Transporter 2 InhibitorsAngiotensin-converting enzyme inhibitorsAngiotensin receptor antagonistsChronic kidney diseaseGlucagon-like peptide 1 receptor agonistsMineralocorticoid receptor antagonistsProteinuriaRenin-angiotensin systemSodium-glucose transporter 2 inhibitors

Identifiers

PMID41528949
PMCPMC12923249

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.