Sodium-glucose cotransporter 2 inhibitors as the first universal treatment of chronic kidney disease

被引:0
作者
El Din, Usama Abdel Azim Sharaf [1 ]
Salem, Mona Mansour [2 ]
Abdulazim, Dina Ossama [3 ]
机构
[1] Cairo Univ, Sch Med, Dept Nephrol, Cairo 11759, Egypt
[2] Cairo Univ, Sch Med, Dept Endocrinol, Cairo 11759, Egypt
[3] Cairo Univ, Sch Med, Dept Rheumatol & Rehabil, Cairo 11759, Egypt
来源
NEFROLOGIA | 2022年 / 42卷 / 04期
关键词
SGLT2; inhibitors; Diabetic nephropathy; CKD; DKD; SERUM URIC-ACID; SGLT2; INHIBITOR; HYDROGEN EXCHANGER; DIABETES-MELLITUS; CARDIOVASCULAR OUTCOMES; EMPAGLIFLOZIN; DAPAGLIFLOZIN; TRANSPORT; MECHANISM; CELLS;
D O I
10.1016/j.nefro.2021.03.014
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
In the last five years, the medical community was astonishingly surprised by the sequential large outcome trials that displayed the renal effects of sodium glucose co-transporter inhibitors (SGLT2Is) in type 2 diabetes mellitus (T2DM) patients with or without chronic kidney disease (CKD). This favorable effect was later disclosed in non-diabetic CKD patients. The EMPA-REG OUTCOME trial was the first trial that showed a reduction for the need for dialysis in patients suffering diabetic kidney disease (DKD) by 55%. This figure is double the score achieved by the angiotensin receptor blocker, Losartan, in RENAAL trial. The need for dialysis in DAPA-CKD trial was reduced in diabetic and non-diabetic CKD patients by 33%. The renal-specific composite outcome was reduced by 39% in EMPA-REG trial, 40% in CAN-VAS study, 47% in DECLARE-TIMI 58 study, 34% in CREDENCE trial, and 44% in DAPA-CKD trial. The greater surprise is the significant favorable effect of SGLT2Is on overall mortality in CKD patients with or without T2DM. Similar survival benefit was not previously encountered with any of the medications used in CKD patients with or without diabetes. In this review, we disclose the results of the DAPA-CKD trial, the CREDENCE trial and those of several cardiovascular outcome trials (CVOT) that used different SGLT2Is and showed that patients with lower eGFR levels may have greater benefit with respect to cardiovascular morbidity than patients with normal kidney function. In addition, we discuss the different mechanisms of action that explain the renal beneficial effects of SGLT2Is. (C) 2021 Sociedad Espanola de Nefrologia. Published by Elsevier Espana, S.L.U.
引用
收藏
页码:390 / 403
页数:14
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