SGLT2is and Renal Protection: From Biological Mechanisms to Real-World Clinical Benefits

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Giovanna Leoncini1, Elisa Russo1, Elisabetta Bussalino1

  • 1Department of Internal Medicine, The University of Genoa and IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy.

International Journal of Molecular Sciences
|April 30, 2021
PubMed

Insights

Sodium-glucose cotransporter 2 inhibitors (SGLT2is) are now standard for preventing and slowing diabetic kidney disease. This review explores their kidney-protective mechanisms and therapeutic potential.

Area of Science:

  • Nephrology
  • Cardiology
  • Endocrinology

Background:

  • Sodium-glucose cotransporter 2 inhibitors (SGLT2is) have emerged as crucial treatments in managing diabetic kidney disease.
  • Recent randomized controlled trials (RCTs) have demonstrated significant cardiovascular and renal benefits of SGLT2is.

Purpose of the Study:

  • To review the biological mechanisms, both renal and extrarenal, responsible for the kidney-protective effects of SGLT2is.
  • To present and discuss data from major cardiovascular and renal outcome trials involving SGLT2is.
  • To provide an overview of the current applications and future therapeutic potential of SGLT2is in patient care.

Main Methods:

  • Narrative review of existing literature.
  • Analysis of data from published randomized controlled trials (RCTs) focusing on cardiovascular and renal outcomes.
  • Discussion of mechanistic studies investigating SGLT2 inhibitor action.

Main Results:

  • SGLT2is have demonstrated efficacy in preventing the onset and progression of diabetic kidney disease.
  • Evidence supports both direct renal and indirect extrarenal mechanisms contributing to kidney protection.
  • Outcome trials highlight the established role of SGLT2is in cardiovascular and renal risk reduction.

Conclusions:

  • SGLT2is represent a cornerstone therapy for patients with diabetic kidney disease, offering significant renoprotective benefits.
  • Understanding the multifaceted mechanisms of SGLT2is can guide future therapeutic strategies.
  • These agents hold substantial promise for expanding their role in managing cardiorenal complications.
Keywords:
SGLT2 inhibitorskidney diseasekidney protection

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