Renoprotective effects of canagliflozin, a sodium glucose cotransporter 2 inhibitor, in type 2 diabetes patients with chronic kidney disease: A randomized open-label prospective trial.

Publisher: Sage Publications Country of Publication: England NLM ID: 101234011 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1752-8984 (Electronic) Linking ISSN: 14791641 NLM ISO Abbreviation: Diab Vasc Dis Res Subsets: MEDLINE

Publication: 2009- : London : Sage Publications
Original Publication: Edgbaston, Birmingham, UK : Sherborne Gibbs, c2005-

Sodium-Glucose Transporter 2 Inhibitors*; Blood Glucose/*drug effects ; Canagliflozin/*therapeutic use ; Diabetes Mellitus, Type 2/*drug therapy ; Diabetic Nephropathies/*drug therapy ; Hypoglycemic Agents/*therapeutic use ; Kidney/*drug effects ; Renal Insufficiency, Chronic/*drug therapy; Acetylglucosaminidase/urine ; Aged ; Albuminuria/drug therapy ; Albuminuria/etiology ; Albuminuria/physiopathology ; Biomarkers/blood ; Biomarkers/urine ; Blood Glucose/metabolism ; Canagliflozin/adverse effects ; Diabetes Mellitus, Type 2/blood ; Diabetes Mellitus, Type 2/complications ; Diabetic Nephropathies/blood ; Diabetic Nephropathies/etiology ; Diabetic Nephropathies/physiopathology ; Disease Progression ; Fatty Acid-Binding Proteins/urine ; Female ; Glomerular Filtration Rate/drug effects ; Humans ; Hypoglycemic Agents/adverse effects ; Japan ; Kidney/metabolism ; Kidney/physiopathology ; Male ; Middle Aged ; Prospective Studies ; Renal Insufficiency, Chronic/blood ; Renal Insufficiency, Chronic/etiology ; Renal Insufficiency, Chronic/physiopathology ; Sodium-Glucose Transporter 2/metabolism ; Time Factors ; Treatment Outcome ; beta 2-Microglobulin/urine

Background: To evaluate the renoprotective effects of canagliflozin, we assessed the albuminuria-lowering effect in Japanese type 2 diabetes patients with chronic kidney disease (CKD).
Methods: In this prospective, open-label, parallel-group study, type 2 diabetes patients with CKD were randomized to receive either oral canagliflozin (100 mg/day) or usual care (control group) for 52 weeks. Endpoints included changes in urinary albumin-to-creatinine ratio (UACR), other urinary biomarkers, laboratory parameters, and adverse events.
Results: Both groups included 20 patients in the analysis. Mean changes in UACR was -83 (-266 to -31) mg/gCr and 27 (-11 to 131) mg/gCr, in the canagliflozin and control groups, respectively ( p = 0.004). Urinary liver-type free acid binding protein, N-acetyl-β-d-glucosaminidase, and β 2 -microglobulin levels were also significantly decreased in the canagliflozin group, but not in the control group. Mean change in estimated glomerular filtration rate at the end of the study was 0.7 and -3.4 mL/min/1.73 m ² in the canagliflozin and control group, respectively ( p = 0.024). Canagliflozin treatment led to improvement of glycaemic control and reduction in body weight, blood pressure, and liver transaminase. There were no adverse events associated with canagliflozin.
Conclusion: Canagliflozin was associated with slower progression of kidney disease and reduction in albuminuria and tubulointerstitial markers in diabetes patients with CKD.

Keywords: Albuminuria; canagliflozin; chronic kidney disease; type 2 diabetes

0 (Biomarkers)
0 (Blood Glucose)
0 (FABP1 protein, human)
0 (Fatty Acid-Binding Proteins)
0 (Hypoglycemic Agents)
0 (SLC5A2 protein, human)
0 (Sodium-Glucose Transporter 2)
0 (Sodium-Glucose Transporter 2 Inhibitors)
0 (beta 2-Microglobulin)
0SAC974Z85 (Canagliflozin)
EC 3.2.1.52 (Acetylglucosaminidase)

Date Created: 20180621 Date Completed: 20181009 Latest Revision: 20181202

20231215

10.1177/1479164118782872

29923427