“肾三联”疗法在T2DM-CKD中的研究进展

Research Progress of “Renal Triple” Therapy in T2DM-CKD

摘要: 2型糖尿病合并慢性肾脏病(T2DM-CKD)是一种临床常见病，且发病率较高。近年来随着新药的研发，该病治疗效果得到一定提高，但就如何更有效地联合治疗、减轻不良反应这方面仍值得关注。最近新提出的“肾三联”疗法(指联合使用肾素–血管紧张素系统抑制剂(RASi)、钠–葡萄糖协同转运蛋白2抑制剂(SGLT2i)和盐皮质激素受体拮抗剂(MRA)三种药物)，为T2DM-CKD的治疗与管理带来了新的突破。本文将从机制基础、临床证据、应用策略及安全性管理、局限性与未来展望四个方面系统阐述“肾三联”疗法在T2DM-CKD中的最新进展，旨在帮助临床医师制定更合理、有效且个体化的2型糖尿病伴慢性肾病管理策略。

Abstract: Type 2 diabetes mellitus with chronic kidney disease (T2DM-CKD) is a clinically common condition with a high incidence. In recent years, the development of new drugs has improved treatment outcomes to some extent, but how to achieve more effective combination therapy and reduce adverse reactions remains a topic of concern. The newly proposed “renal triple therapy” (referring to the combined use of three medications: renin-angiotensin system inhibitors (RASi), sodium-glucose cotransporter-2 inhibitors (SGLT2i), and mineralocorticoid receptor antagonists (MRA)) has brought a breakthrough in the treatment and management of T2DM-CKD. This article systematically reviews the latest advances in renal triple therapy for T2DM-CKD from four perspectives: mechanistic basis, clinical evidence, application strategies and safety management, as well as limitations and future prospects, aiming to assist clinicians in developing more rational, effective, and personalized management strategies for type 2 diabetes with chronic kidney disease.