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Renal physiology of glucose handling and therapeutic implications.
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- Author(s): Cherney DZ;Cherney DZ;Cherney DZ;Cherney DZ;Cherney DZ; Kanbay M; Kanbay M; Lovshin JA; Lovshin JA; Lovshin JA; Lovshin JA; Lovshin JA
- Source:
Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association [Nephrol Dial Transplant] 2020 Jan 01; Vol. 35 (Suppl 1), pp. i3-i12.- Publication Type:
Journal Article; Research Support, Non-U.S. Gov't; Review- Language:
English - Source:
- Additional Information
- Source: Publisher: Oxford University Press Country of Publication: England NLM ID: 8706402 Publication Model: Print Cited Medium: Internet ISSN: 1460-2385 (Electronic) Linking ISSN: 09310509 NLM ISO Abbreviation: Nephrol Dial Transplant Subsets: MEDLINE
- Publication Information: Publication: Oxford : Oxford University Press
Original Publication: [Berlin ; New York, NY] : Springer International, [c1986- - Subject Terms: Diabetes Mellitus, Type 2/*drug therapy ; Glucose/*metabolism ; Hypoglycemic Agents/*pharmacology ; Kidney/*drug effects ; Renal Insufficiency, Chronic/*prevention & control ; Sodium-Glucose Transporter 2 Inhibitors/*pharmacology; Diabetes Mellitus, Type 2/metabolism ; Diabetes Mellitus, Type 2/pathology ; Glomerular Filtration Rate ; Humans ; Kidney/physiopathology ; Renal Insufficiency, Chronic/pathology
- Abstract: The rationale for using sodium-glucose cotransporter 2 (SGLT2) inhibitors in patients with type 2 diabetes (T2D) has evolved over the last decade. Due to the effects on glucosuria and body weight loss, SGLT2 inhibitors were originally approved for glycemic control in T2D. Since glucosuria is attenuated in chronic kidney disease (CKD) Stages 3-5, initial regulatory approval for SGLT2 inhibitor use was limited to patients with T2D and preserved estimated glomerular filtration rate. Over time, however, it has become increasingly apparent that these therapies have a variety of important pharmacodynamic and clinical effects beyond glycemic lowering, including antihypertensive and antialbuminuric properties, and the ability to reduce glomerular hypertension. Importantly, these sodium-related effects are preserved across CKD stages, despite attenuated glycemic effects, which are lost at CKD Stage 4. With the completion of cardiovascular (CV) outcome safety trials-EMPA-REG OUTCOME, CANVAS Program and DECLARE TIMI-58-in addition to reductions in CV events, SGLT2 inhibition consistently reduces hard renal endpoints. Importantly, these CV and renal effects are independent of glycemic control. Subsequent data from the recent CREDENCE trial-the first dedicated renal protection trial with SGLT-2 inhibition-demonstrated renal and CV benefits in albuminuric T2D patients, pivotal results that have expanded the clinical importance of these therapies. Ongoing trials will ultimately determine whether SGLT2 inhibition will have a role in renal protection in other clinical settings, including nondiabetic CKD and type 1 diabetes.
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- Contributed Indexing: Keywords: cardiovascular disease; diabetes; diabetic kidney disease; heart failure
- Accession Number: 0 (Hypoglycemic Agents)
0 (Sodium-Glucose Transporter 2 Inhibitors)
IY9XDZ35W2 (Glucose) - Publication Date: Date Created: 20200201 Date Completed: 20200904 Latest Revision: 20200904
- Publication Date: 20231215
- Accession Number: PMC6993194
- Accession Number: 10.1093/ndt/gfz230
- Accession Number: 32003835
- Source:
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