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Sodium-Glucose Cotransporter 2 Inhibitors in Patients with Non-Diabetic Chronic Kidney Disease

Akira Mima1

  • 1Department of Nephrology, Osaka Medical and Pharmaceutical University, Osaka, 569-8686, Japan. akira.mima@ompu.ac.jp.

Advances in Therapy
|April 16, 2021
PubMed
Abstract

Insights

Sodium-glucose cotransporter 2 (SGLT2) inhibitors show promise in treating chronic kidney disease (CKD). Recent trials indicate SGLT2 inhibitors reduce cardiovascular events and slow renal impairment in patients with or without diabetes.

Area of Science:

  • Nephrology
  • Cardiology
  • Pharmacology

Background:

  • Sodium-glucose cotransporter 2 (SGLT2) inhibitors are established treatments for type 2 diabetes, reducing cardiovascular morbidity and mortality.
  • Emerging evidence suggests SGLT2 inhibitors also protect renal function in diabetic patients.
  • The efficacy of SGLT2 inhibitors in non-diabetic chronic kidney disease (CKD) remained uncertain.

Purpose of the Study:

  • To investigate the effects of SGLT2 inhibitors on cardiovascular and renal outcomes in patients with CKD, including those without diabetes.
  • To evaluate the Dapagliflozin and Prevention of Adverse outcomes in Chronic Kidney Disease (DAPA-CKD) trial findings.

Main Methods:

  • The DAPA-CKD trial assessed dapagliflozin's impact on a composite renal and cardiovascular death endpoint in CKD patients.
  • Participants included individuals with and without type 2 diabetes, on standard renoprotective therapy.

Main Results:

  • Dapagliflozin significantly reduced the hazard ratio for the composite endpoint in CKD patients.
  • Benefits were observed regardless of diabetes status or baseline estimated glomerular filtration rate.
  • Previous trials like DAPA-HF and EMPEROR-Reduced demonstrated cardiovascular benefits of SGLT2 inhibitors in heart failure, irrespective of diabetes.

Conclusions:

  • SGLT2 inhibitors, exemplified by dapagliflozin, offer significant renal and cardiovascular protection in patients with CKD.
  • These findings extend the therapeutic potential of SGLT2 inhibitors beyond diabetes management.
Keywords:
Chronic kidney disease (CKD)Hypoxia-inducible factor (HIF)InflammationOxidative stressSodium-glucose cotransporter 2 (SGLT2) inhibitorsTubuloglomerular feedback (TGF)

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