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Sodium-Glucose Cotransporter-2 Inhibitors Could Help Delay Renal Impairment in Patients with Type 2 Diabetes: A

Gyunam Park1, Byungha Choi1,2, Soyoung Kang1,3

  • 1Department of Pharmacy and Yonsei Institute of Pharmaceutical Sciences, Yonsei University, Incheon 21983, Korea.

Journal of Clinical Medicine
|September 23, 2022
PubMed

Insights

Sodium-glucose cotransporter-2 (SGLT2) inhibitors demonstrated superior renoprotective effects compared to dipeptidyl peptidase-4 (DPP-4) inhibitors in type 2 diabetes mellitus patients. SGLT2 inhibitors significantly reduced renal events and slowed estimated glomerular filtration rate decline.

Area of Science:

  • Nephrology
  • Endocrinology
  • Pharmacology

Background:

  • Type 2 diabetes mellitus (T2DM) is a leading cause of chronic kidney disease.
  • Both sodium-glucose cotransporter-2 (SGLT2) inhibitors and dipeptidyl peptidase-4 (DPP-4) inhibitors are used to manage T2DM.
  • Comparative data on their long-term renoprotective effects are crucial.

Purpose of the Study:

  • To compare the renoprotective efficacy of SGLT2 inhibitors versus DPP-4 inhibitors in T2DM patients.
  • To evaluate the impact of these drug classes on renal function decline and serum uric acid levels.

Main Methods:

  • Retrospective cohort study utilizing electronic medical records.
  • Inclusion of 2396 T2DM patients, with 1198 in each treatment group (SGLT2 inhibitors vs. DPP-4 inhibitors).
  • Primary outcome: first occurrence of estimated glomerular filtration rate (eGFR) <45 mL/min/1.73 m2; secondary analysis of eGFR and serum uric acid (SUA) changes.

Main Results:

  • Significantly lower rate of renal events in the SGLT2 inhibitors group (HR, 0.46; p = 0.0007).
  • Slower annual mean eGFR decline in the SGLT2 inhibitors group (0.86 mL/min/1.73 m2/year; p < 0.0001).
  • Lower mean serum uric acid levels observed with SGLT2 inhibitors.

Conclusions:

  • SGLT2 inhibitors exhibit superior renoprotective properties compared to DPP-4 inhibitors in T2DM.
  • These findings suggest SGLT2 inhibitors can delay the progression of renal impairment in T2DM patients.
  • The reduction in eGFR decline and SUA levels highlights a potential mechanism for renoprotection.
Keywords:
antidiabetic drugdiabetic kidney disease (DKD)renoprotective effectsodium–glucose cotransporter-2 (SGLT2) inhibitor

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