Article ; Online: Sodium-glucose cotransporter 2 inhibitors: extending the indication to non-diabetic kidney disease?
2020 Volume 35, Issue Suppl 1, Page(s) i33–i42
Abstract: This year the medical community was pleasantly surprised by the results of the first large outcome trial that primarily examined the renal effects of the sodium-glucose cotransporter 2 (SGLT2) inhibitor canagliflozin (CANA) in subjects with diabetes and ... ...
Abstract | This year the medical community was pleasantly surprised by the results of the first large outcome trial that primarily examined the renal effects of the sodium-glucose cotransporter 2 (SGLT2) inhibitor canagliflozin (CANA) in subjects with diabetes and impaired kidney function. The Evaluation of the Effects of Canagliflozin on Renal and Cardiovascular Outcomes in Participants With Diabetic Nephropathy (CREDENCE) trial showed that CANA, relative to placebo, reduces the risk for end-stage renal disease, doubling of creatinine or renal death by 34% [hazard ratio 0.66 (95% confidence interval 0.53-0.81]. These effects were consistent across baseline estimated glomerular filtration rate (eGFR) and haemoglobin A1c subgroups. In this review we combine the results of the CREDENCE trial with those of several cardiovascular outcome trials with SGLT2 inhibitors and show that, unexpectedly, patients with lower eGFR levels may have greater benefit with respect to cardiovascular outcome than patients with normal kidney function. The cardio- and renoprotective effects of SGLT2 inhibitors seem to be independent of their glucose-lowering effects, as shown in several post hoc analyses. In this review we discuss the alleged mechanisms of action that explain the beneficial effects of this novel class of drugs. Moreover, we discuss whether these findings indicate that this class of drugs may also be beneficial in non-diabetic chronic kidney diseases. |
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MeSH term(s) | Humans ; Prognosis ; Renal Insufficiency, Chronic/drug therapy ; Renal Insufficiency, Chronic/metabolism ; Renal Insufficiency, Chronic/pathology ; Sodium-Glucose Transporter 2/chemistry ; Sodium-Glucose Transporter 2 Inhibitors/therapeutic use |
Chemical Substances | SLC5A2 protein, human ; Sodium-Glucose Transporter 2 ; Sodium-Glucose Transporter 2 Inhibitors |
Language | English |
Publishing date | 2020-01-28 |
Publishing country | England |
Document type | Journal Article ; Review |
ZDB-ID | 90594-x |
ISSN | 1460-2385 ; 0931-0509 |
ISSN (online) | 1460-2385 |
ISSN | 0931-0509 |
DOI | 10.1093/ndt/gfz264 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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