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Sodium-glucose Cotransporter 2 Inhibitors: Nephroprotective Impact on Diabetic Kidney Disease

[ Vol. 18 , Issue. 2 ]

Author(s):

Konstantinos Stavropoulos*, Konstantinos P. Imprialos, Nikiforos Stavropoulos, Sofia Bouloukou, Georgios Kerpiniotis, Kyriakos Dimitriadis, Constantinos Tsioufis and Michael Doumas   Pages 120 - 126 ( 7 )

Abstract:


Background: Diabetic nephropathy is a crucial microvascular complication of diabetes mellitus that is associated with elevated cardiovascular risk. SGLT-2 inhibitors are a new class of hypoglycemic drugs that positively affect several risk factors of cardiorenal damage.

Objectives: The study aimed to review and critically discuss available data on the association of SGLT-2 inhibitors treatment with kidney function, progress of diabetic kidney disease, and renal related outcomes, as well to unveil potential mechanisms of action that mediate such effects.

Method: We conducted a comprehensive search of the literature on the renal related effects of SGLT-2 inhibitors, to compose a narrative mini-review.

Results: The administration of SGLT-2 inhibitors was observed to exert beneficial effects on a wide cluster of risk factors of chronic kidney disease, such as hyperglycemia, blood pressure, serum uric acid, and body weight. Data from the first two large, randomized, clinical trials of SGLT-2 inhibitors conducted to address the renal related outcomes of SGLT-2 inhibitors suggest substantial benefits on estimated glomerular filtration rate decline and albuminuria.

Conclusion: The initial data suggest clinically meaningful benefits of the SGLT-2 inhibitors in diabetic patients in relevance with chronic kidney disease. Future, well-designed randomised clinical trials need to be further investigated such as nephroprotective outcomes, that if confirmed, could lead to new perspectives in the management of diabetic nephropathy.

Keywords:

SGLT-2 inhibitors, diabetic kidney disease, albuminuria, glomerular filtration rate, cardiovascular disease, hyperglycemia.

Affiliation:

Second Propedeutic Department of Internal Medicine, Hippokration Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, Second Propedeutic Department of Internal Medicine, Hippokration Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, Institute of Cardiovascular and Medical Science, University of Glasgow, Glasgow, Second Propedeutic Department of Internal Medicine, Hippokration Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, Second Propedeutic Department of Internal Medicine, Hippokration Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, First Department of Cardiology, Hippokration Hospital, University of Athens, Athens, Veterans Affairs Medical Center, Georgetown University, Washington, DC, Veterans Affairs Medical Center, George Washington University, Washington, DC

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