Related Experiment Video

Updated: Apr 8, 2026

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

826

Cardiorenal protective effects of anti-diabetic drugs in early stage Cardiovascular-Kidney-Metabolic Syndrome: A

Wen-Rui Hao1, Ju-Chi Liu1, Yu-Ann Fang2

  • 1Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan; Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.

Diabetes Research and Clinical Practice
|April 6, 2026
PubMed

Insights

Sodium-glucose cotransporter-2 inhibitors (SGLT2i) offer superior kidney protection and survival benefits in early cardiovascular-kidney-metabolic (CKM) syndrome compared to other antidiabetic agents. Most agents reduced cardiovascular risk, but SGLT2i demonstrated the best outcomes.

Area of Science:

  • Cardiology
  • Nephrology
  • Endocrinology
  • Metabolic Syndrome Research

Background:

  • Cardiovascular-kidney-metabolic (CKM) syndrome integrates metabolic risk factors with cardiorenal complications.
  • Real-world data comparing cardiorenal outcomes of various antidiabetic agents (ADAs) in early CKM stages are limited.

Purpose of the Study:

  • To compare the cardiorenal outcomes of different classes of antidiabetic agents (ADAs) in patients with early-stage CKM syndrome.
  • To evaluate the association between specific ADAs and risks of stroke, acute myocardial infarction (AMI), end-stage renal disease (ESRD), and all-cause mortality.

Main Methods:

  • Retrospective cohort study utilizing the Taipei Medical University Clinical Research Database.
  • Inclusion of adult patients newly diagnosed with diabetes initiating ADAs between 2016 and 2019.
  • Time-varying Cox proportional hazards models to assess risks associated with eight ADA classes versus non-use.

Main Results:

  • Most ADAs showed reduced cardiovascular risk compared to non-use.
  • Insulin therapy was linked to increased risks of stroke (aHR 1.65) and AMI (aHR 2.47).
  • Compared to sodium-glucose cotransporter-2 inhibitors (SGLT2i), other ADAs had higher risks of ESRD (aHR 3.62-19.16) and all-cause mortality (aHR 5.80-66.84).
  • SGLT2i absence correlated with higher ESRD risk in younger, obese patients.

Conclusions:

  • In early CKM syndrome, most ADAs mitigate cardiovascular risk.
  • Sodium-glucose cotransporter-2 inhibitors (SGLT2i) demonstrate superior renal protection and survival benefits.
  • SGLT2i are recommended for improved cardiorenal outcomes and longevity in early CKM stages.
Abstract

Keywords:
Anti-diabetic AgentsCardiovascular-Kidney-Metabolic SyndromeEnd-Stage Renal DiseaseReal-World EvidenceSGLT2 Inhibitors

More Related Videos

Early Detection of Drug-Induced Renal Hemodynamic Dysfunction Using Sonographic Technology in Rats06:38

Early Detection of Drug-Induced Renal Hemodynamic Dysfunction Using Sonographic Technology in Rats

Published on: March 11, 2016

12.7K

Related Concept Videos

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
1.4K
Heart Failure Drugs: Diuretics01:22

Heart Failure Drugs: Diuretics

Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
1.2K
Antihypertensive Drugs: Direct Renin Inhibitors01:25

Antihypertensive Drugs: Direct Renin Inhibitors

The renin-angiotensin-aldosterone system (RAAS) is an intricate physiological pathway involving numerous enzymes and hormones, including renin, angiotensin-converting enzyme (ACE), angiotensin I and II, and aldosterone. Imbalances within this system increase the production of angiotensin II and aldosterone. Increased angiotensin II levels promote vasoconstriction and blood pressure elevation. Concurrently, higher aldosterone levels stimulate sodium and water reabsorption in the kidneys,...
1.8K
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...
507
Antihypertensive Drugs: Potassium-Sparing Diuretics01:28

Antihypertensive Drugs: Potassium-Sparing Diuretics

Liddle syndrome is a genetically inherited form of hypertension characterized by the overactivity of epithelial sodium channels in the nephron, the functional unit of the kidney. This heightened activity leads to increased sodium reabsorption and excessive excretion of potassium. To counteract this, potassium-sparing diuretics such as amiloride are used. They function by blocking these sodium channels, thereby reducing the influx of sodium into the epithelial cells and minimizing the loss of...
2.7K
Antihypertensive Drugs: Action of Diuretics01:16

Antihypertensive Drugs: Action of Diuretics

Diuretics are antihypertensive drugs used to treat hypertension resulting from sodium and water retention. Sodium, vital for fluid balance and nerve or muscle function, is regulated by the kidneys through millions of nephrons. Blood enters nephrons via afferent arterioles, which branch into capillaries called glomeruli. These filter blood plasma, allowing water and solutes, like sodium ions, to pass through capillary walls into Bowman's capsule. The filtrate then flows through various...
2.8K