Related Experiment Video

Updated: Sep 6, 2025

Comparative Proteomic Analysis of Whole Kidney, Medulla, and Cortical Tubules in Diabetic Pathogenesis of Kidney Injury in Mice
10:31

Comparative Proteomic Analysis of Whole Kidney, Medulla, and Cortical Tubules in Diabetic Pathogenesis of Kidney Injury in Mice

Published on: May 2, 2025

278

A real-world study on SGLT2 inhibitors and diabetic kidney disease progression

Allen Yan Lun Liu1, Serena Low2, Ester Yeoh3

  • 1Department of General Medicine, Khoo Teck Puat Hospital, Singapore.

Clinical Kidney Journal
|June 27, 2022
PubMed
Abstract

Insights

Sodium-glucose cotransporter 2 inhibitors (SGLT2is) significantly reduce chronic kidney disease (CKD) progression and end-stage kidney disease (ESKD) in type 2 diabetes mellitus (T2DM) patients. These benefits are more pronounced in individuals with moderate to advanced CKD.

Area of Science:

  • Nephrology
  • Endocrinology
  • Pharmacology

Background:

  • Randomized controlled trials confirm sodium-glucose cotransporter 2 inhibitors (SGLT2is) benefits for type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD).
  • Real-world data on SGLT2is' impact on CKD progression and end-stage kidney disease (ESKD) development is limited.
  • Diabetic kidney disease (DKD) is highly prevalent, necessitating real-world outcome studies.

Purpose of the Study:

  • To evaluate the renal outcomes of patients with diabetic kidney disease (DKD) treated with SGLT2 inhibitors.
  • To assess the effect of SGLT2 inhibitors on CKD progression and the development of ESKD in a real-world setting.
  • To compare SGLT2 inhibitors with standard treatments for DKD.

Main Methods:

  • A cohort of T2DM patients from renal and diabetic clinics in Singapore (2016-2019) was analyzed.
  • Patients receiving SGLT2 inhibitors were compared to those on standard anti-diabetic and renoprotective therapy.
  • Primary outcomes included CKD progression (≥25% eGFR decrease) and ESKD (eGFR <15 mL/min/1.73 m²).

Main Results:

  • A total of 4446 patients were analyzed, with 1598 on SGLT2 inhibitors.
  • SGLT2 inhibitors significantly reduced CKD progression (HR 0.60) and ESKD risk (HR 0.33).
  • Empagliflozin demonstrated sustained renal risk reduction across CKD stages 1-4 compared to other SGLT2is.

Conclusions:

  • This real-world study confirms the renal protective benefits of SGLT2 inhibitors in DKD patients.
  • SGLT2 inhibitors significantly slow CKD progression and reduce the risk of ESKD.
  • The renoprotective effects of SGLT2 inhibitors are more pronounced in patients with moderate to advanced CKD.
Keywords:
CKD progressionESKDSGLT2isdiabetes mellitusdiabetic kidney diseasereal-world study

More Related Videos

Assessment of Kidney Function in Mouse Models of Glomerular Disease09:16

Assessment of Kidney Function in Mouse Models of Glomerular Disease

Published on: June 30, 2018

17.8K
Author Spotlight: Network Pharmacology and Molecular Docking to Decipher the Action of Jiawei Shengjiang San Against Diabetic Kidney Disease08:15

Author Spotlight: Network Pharmacology and Molecular Docking to Decipher the Action of Jiawei Shengjiang San Against Diabetic Kidney Disease

Published on: May 10, 2024

645

Related Concept Videos

Dipeptidyl Peptidase 4 Inhibitors01:23

Dipeptidyl Peptidase 4 Inhibitors

Dipeptidyl peptidase 4 (DPP-4) is a serine protease widely distributed in the body. It's involved in the inactivation of GLP-1 and GIP hormones, which are crucial for insulin regulation. DPP-4 inhibitors, such as sitagliptin (Januvia), saxagliptin (Onglyza), linagliptin (Tradjenta), alogliptin (Nesina), and vildagliptin (Galvus), help increase the proportion of active GLP-1, enhancing insulin secretion. These inhibitors work by competitively binding to DPP-4. This binding causes a...
248
Oral Hypoglycemic Agents: Biguanides and Glitazones01:26

Oral Hypoglycemic Agents: Biguanides and Glitazones

Biguanides, particularly metformin (Glucophage), are insulin sensitizers that enhance glucose uptake, thereby reducing insulin resistance. Unlike sulfonylureas, metformin doesn't prompt insulin secretion, which helps to curb hypoglycemia risk. Metformin is beneficial in treating conditions like polycystic ovary syndrome due to its insulin-resistance reduction capability. The drug's primary action involves curtailing hepatic gluconeogenesis, a significant contributor to high blood...
284
Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
56
Chronic Kidney Disease III: Interprofessional Care01:28

Chronic Kidney Disease III: Interprofessional Care

Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
77
Glucose Transporters01:27

Glucose Transporters

Glucose transporters facilitate the transport of glucose across the cell membrane. In addition to glucose, some glucose transporters can also aid the movement of other hexoses such as fructose, mannose, and galactose.
Facilitated diffusion-glucose transporters (GLUTs) are encoded by the solute-linked carrier (SLC) family 2, subfamily A gene family, or SLC2A. The 14 GLUT protein members are distributed into three classes:
24.1K
Oral Hypoglycemic Agents: Glinides01:06

Oral Hypoglycemic Agents: Glinides

Repaglinide (Prandin) and Nateglinide (Starlix), known as glinides, are oral insulin secretagogues that stimulate insulin release from pancreatic β cells by closing the ATP-sensitive potassium channels (KATP channel). Repaglinide controls insulin release from pancreatic β cells by managing potassium efflux. It shares two binding sites with sulfonylureas and also has a unique site, indicating overlapping mechanisms of action. With a rapid onset and a 4-7 hour duration, it effectively...
254