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Renal Protection and Safety of Sodium-glucose Cotransporter-2 Inhibitors in Chronic Kidney Disease
Tianbiao Zhou1, Kaijin Yao1, Yina Xie1
1Department of Nephrology, the Second Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China.
Introduction:
Chronic kidney disease (CKD) has a clinical characteristic of progressive loss of kidney function and becomes a serious health and social concern. SGLT2i (sodium-glucose cotransporter 2 inhibitors), a class of anti-diabetic medications, are shown to reduce cardiovascular and renal events. This systematic review and meta-analysis aimed to assess whether SGLT2i could become a new treatment strategy for CKD for its renal protection and safety.
Methods:
Based on predetermined criteria, a bibliographical search was performed on May 31, 2022, by searching the following databases: ISI Web of Science, Embase, PubMed, and the Cochrane Library. Statistical analysis was conducted to assess renal protection and safety of SGLT2i by using Cochrane Review Manager Version 5.3.
Results:
Thirty randomised controlled trials fulfilled the inclusion criteria and were eligible for this meta-analysis. Our study found that the SGLT2i can sustainably reduce the urine albumin/creatinine ratio (UACR) at different time points and prevent the progression to macroalbuminuria. Before 24 weeks, SGLT2i can decrease the estimated glomerular filtration rate (eGFR) compared to the control group. Interestingly, after 24 weeks, SGLT2i can continuously maintain the increase in eGFR when compared with the control group. Furthermore, SGLT2i can reduce the event rates of incident or worsening nephropathy, a decline in estimated eGFR of ≥ 50%, doubling of serum creatinine level, acute renal failure and renal failure. Interestingly, the renoprotective effects of SGLT2i are independent of its glycemic effects. SGLT2i can reduce the morbidity rate of any related adverse events, any related severe adverse events and SGLT2i have not increased the event rates of urinary tract infection, bone fractures, amputation, and acute pancreatitis when compared with the control group.
Conclusion:
SGLT2i can protect renal function and are safe drug for CKD. SGLT2i are promising therapeutic agents for CKD patients.
Insights
Sodium-glucose cotransporter 2 inhibitors (SGLT2i) offer significant renal protection for chronic kidney disease (CKD) patients. This meta-analysis confirms SGLT2i are safe and effective in slowing CKD progression and improving kidney function.
Area of Science:
- Nephrology
- Pharmacology
- Internal Medicine
Background:
- Chronic kidney disease (CKD) is characterized by progressive kidney function loss, posing a significant health challenge.
- Sodium-glucose cotransporter 2 inhibitors (SGLT2i), initially developed as anti-diabetic drugs, have demonstrated potential cardiovascular and renal benefits.
Conclusions:
- SGLT2 inhibitors demonstrate significant renal protective effects and a favorable safety profile in patients with CKD.
- These findings suggest SGLT2 inhibitors are promising therapeutic agents for managing chronic kidney disease.
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