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Metformin versus SGLT-2 inhibitors: how low can we go?

Menno Pruijm1, Olivier Phan1, Anne Zanchi2

  • 1Service of Nephrology and Hypertension, Lausanne University Hospital and University of Lausanne, Department of Medicine, Lausanne, Switzerland.

Kidney International
|April 24, 2022
PubMed

Insights

Metformin halted chronic kidney disease progression in rats, while canagliflozin did not. Further research is needed to compare these treatments in advanced human kidney disease.

Area of Science:

  • Nephrology
  • Pharmacology
  • Translational Medicine

Background:

  • Chronic kidney disease (CKD) progression is challenging to halt.
  • Metformin and sodium-glucose cotransporter 2 inhibitors (SGLT2i) are potential treatments.
  • Head-to-head clinical trials in advanced CKD (stage 3b-4) are limited due to safety concerns.

Purpose of the Study:

  • To compare the effects of metformin and canagliflozin on CKD progression.
  • To evaluate safety and efficacy in a preclinical model.

Main Methods:

  • Adenine-induced moderate CKD (stage 2-4) in rats.
  • Administration of metformin versus canagliflozin.
  • Assessment of kidney disease progression markers.

Main Results:

  • Metformin significantly halted the progression of chronic kidney disease.
  • Canagliflozin did not demonstrate a similar effect in halting disease progression.
  • The study provides a preclinical comparison of these two therapeutic agents.

Conclusions:

  • Metformin may be more effective than canagliflozin in halting established CKD progression in this model.
  • Further investigation is warranted to explore these findings in human clinical trials.
  • The results offer valuable insights for managing advanced chronic kidney disease.

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