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Sodium glucose co-transporter 2 inhibitors (SGLT2i) for pediatric kidney disease: the future is near

Gilda M Portalatin1, Irene Hong-McAtee2,3, Anna M Burgner1

  • 1Division of Nephrology, Vanderbilt University Medical Center, Nashville, TN, United States.

Frontiers in Pediatrics
|February 14, 2025
PubMed

Insights

Sodium glucose co-transporter 2 (SGLT2) inhibitors show significant cardiovascular and kidney benefits, extending beyond diabetes. Further research is needed to establish their efficacy and safety in pediatric kidney diseases.

Area of Science:

  • Nephrology
  • Endocrinology
  • Pharmacology

Background:

  • Sodium glucose co-transporter 2 (SGLT2) reabsorbs glucose in the proximal tubule.
  • SGLT2 inhibitors promote renal glucose excretion, improving glycemic control.
  • Studies revealed cardiovascular and kidney benefits of SGLT2 inhibition beyond diabetes management.

Purpose of the Study:

  • To review the kidney protective effects of SGLT2 inhibitors in adults.
  • To explore mechanisms contributing to improved kidney outcomes.
  • To assess the current data and future research needs for SGLT2 inhibitors in pediatric kidney disease.

Main Methods:

  • Literature review of studies on SGLT2 inhibitors.
  • Analysis of data on cardiovascular and kidney outcomes.
  • Examination of pediatric data and dosing patterns.

Main Results:

  • SGLT2 inhibition demonstrates significant cardiovascular and kidney benefits in adults, including those without diabetes.
  • These benefits in chronic kidney disease (CKD) highlight the potential for SGLT2 inhibitors in pediatric nephrology.
  • Limited data exists for SGLT2 inhibitor use in pediatric kidney disease, necessitating further trials.

Conclusions:

  • SGLT2 inhibitors offer substantial kidney protection in adults, with benefits extending beyond diabetes.
  • Pediatric nephrologists should become familiar with SGLT2 inhibitor therapies.
  • Randomized controlled trials are crucial to evaluate SGLT2 inhibitors in pediatric kidney patients.

Keywords:
IgA nephropathySGLT2 inhibitorscanagliflozinchronic kidney diseasedapagliflozinempagliflozinpediatric chronic kidney diseaseproteinuria

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