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SGLT2 inhibitors and the kidney: Effects and mechanisms

V Tsimihodimos1, T D Filippatos2, M S Elisaf1

  • 1Department of Internal Medicine, School of Medicine, University of Ioannina, Ioannina, Greece.

Diabetes & Metabolic Syndrome
|June 18, 2018
PubMed
Abstract

Insights

Sodium glucose cotransporter 2 (SGLT2) inhibitors improve kidney function and reduce renal endpoints. This review details their protective mechanisms and risks of acute kidney injury.

Area of Science:

  • Nephrology
  • Pharmacology
  • Cardiorenal Medicine

Background:

  • Sodium glucose cotransporter 2 (SGLT2) inhibitors are established treatments for type 2 diabetes.
  • Clinical trials demonstrate their benefits on renal function and hard renal outcomes.

Purpose of the Study:

  • To review the nephroprotective mechanisms of SGLT2 inhibitors.
  • To identify risk factors for acute kidney injury (AKI) in patients using SGLT2 inhibitors.

Main Methods:

  • Comprehensive literature review of preclinical and clinical studies.
  • Analysis of data on renal hemodynamics, metabolism, and blood pressure effects.
  • Evaluation of reported cases of AKI associated with SGLT2 inhibitors.

Main Results:

  • SGLT2 inhibitors favorably impact albuminuria and slow glomerular filtration rate decline.
  • Renal hemodynamics appear to be a key renoprotective mechanism.
  • Other proposed mechanisms include metabolic and blood pressure benefits.

Conclusions:

  • SGLT2 inhibitors offer significant renal protection through multiple proposed mechanisms.
  • Understanding these mechanisms is crucial for optimizing patient care and minimizing AKI risk.
Keywords:
Acute kidney injuryKetonesKey wordsKidneyNephroprotectionSodium glucose cotransporter 2

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