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Role of SGLT-2 Inhibitors in Ultrafiltration Failure in Peritoneal Dialysis: A Narrative Review

Magdalena Riedl Khursigara1, Ping Liu2, Reetinder Kaur3

  • 1Broad Institute of MIT and Harvard, Cambridge, MA, USA.

Canadian Journal of Kidney Health and Disease
|November 6, 2024
PubMed
Abstract

Insights

Sodium-glucose co-transporter-2 (SGLT-2) inhibitors show promise for preventing ultrafiltration failure in peritoneal dialysis (PD) patients. Further research is needed to confirm their benefits in advanced chronic kidney disease (CKD).

Area of Science:

  • Nephrology
  • Pharmacology
  • Cardiovascular Medicine

Background:

  • Sodium-glucose co-transporter-2 (SGLT-2) inhibitors are established glucose-lowering agents with proven cardiovascular and kidney-protective benefits.
  • Their efficacy in advanced chronic kidney disease (CKD) and maintenance dialysis patients remains under investigation.
  • Ultrafiltration failure is a significant complication in peritoneal dialysis (PD), often linked to glucose transporter activity.

Purpose of the Study:

  • To review current data on SGLT-2 inhibitors in advanced CKD and PD.
  • To explore the potential role of SGLT-2 inhibitors in preventing ultrafiltration failure in PD.
  • To consider the design of future clinical trials for SGLT-2 inhibitors in PD patients.

Main Methods:

  • Literature review of animal models and ongoing clinical trials.
  • Information sourced from clinicaltrials.gov.
  • Analysis of peritoneal membrane glucose transporter expression in animal models.

Main Results:

  • Animal models suggest SGLT-2 inhibitors may influence glucose absorption and ultrafiltration in the peritoneal membrane.
  • Several clinical trials investigating SGLT-2 inhibitors in PD patients are currently underway.
  • Proposed patient-centered approaches for future SGLT-2 inhibitor trials in PD.

Conclusions:

  • SGLT-2 inhibitors present a potential therapeutic strategy for mitigating ultrafiltration failure in PD.
  • Further clinical investigation is warranted to establish the safety and efficacy of SGLT-2 inhibitors in PD patients.
  • Implications for individuals with kidney failure, particularly in underserved communities, are considered.
Keywords:
SGLT-2 inhibitoranimal modelsperitoneal dialysisproof-of-concept studyultrafiltration failure

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