Related Experiment Video

Updated: Apr 14, 2026

Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion
08:35

Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion

Published on: May 26, 2022

4.5K

Implementing sodium-glucose co-transporter 2 inhibitors in cardiovascular-kidney-metabolic syndrome: a

Angelo Avogaro1, Mauro Gori2, Giuseppe Grandaliano3,4

  • 1Laboratory of Experimental Diabetology, Veneto Institute of Molecular Medicine, Via Giuseppe Orus 2, 35129 Padua, Italy.

European Heart Journal. Cardiovascular Pharmacotherapy
|April 12, 2026
PubMed
Abstract

Insights

Sodium-glucose co-transporter 2 inhibitors (SGLT2i) offer organ protection for cardiovascular-kidney-metabolic (CKM) syndrome but are underused. This expert opinion provides strategies for earlier, effective SGLT2i implementation in CKM patients.

Area of Science:

  • Cardiology
  • Nephrology
  • Endocrinology
  • Metabolic Diseases

Background:

  • Cardiovascular-kidney-metabolic (CKM) syndrome is a continuum of organ dysfunction.
  • Sodium-glucose co-transporter 2 inhibitors (SGLT2i) demonstrate significant organ-protective benefits across CKM spectrum.
  • Suboptimal clinical implementation of SGLT2i persists despite evidence.

Purpose of the Study:

  • To translate evidence and guidelines into practical strategies for SGLT2i implementation in CKM syndrome.
  • To address barriers hindering the early and effective use of SGLT2i.
  • To foster integrated care models for CKM syndrome management.

Main Methods:

  • Multidisciplinary expert panel review of clinical trial data, guidelines, and real-world evidence.
  • Informal roundtable discussions to formulate clinical recommendations.
  • Identification of implementation gaps and proposal of actionable solutions.

Main Results:

  • SGLT2i underutilization is attributed to fragmented care, therapeutic inertia, and safety misconceptions.
  • Key barriers include lack of cross-specialty collaboration and educational deficits.
  • Proposed solutions involve early risk screening and simplified treatment algorithms.

Conclusions:

  • Proactive CKM management necessitates an integrated care model focused on early, organ-protective interventions.
  • SGLT2i should be considered foundational, disease-modifying therapy.
  • Multidisciplinary coordination, clear algorithms, and patient-centered communication are crucial for optimal outcomes.
Keywords:
CKM syndromeCardiovascularCardiovascular–kidney–metabolic syndromeCardio–kidney–metabolic syndromeCardio–renal–metabolic syndromeSGLT2 inhibitorsSodium-glucose co-transporter 2 inhibitorsand metabolic disordersrenal

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...
1.5K
Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
567
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,...
1.9K
Oral Hypoglycemic Agents: Biguanides and Glitazones01:26

Oral Hypoglycemic Agents: Biguanides and Glitazones

Biguanides, particularly metformin (Glucophage), are insulin sensitizers that enhance glucose uptake, thereby reducing insulin resistance. Unlike sulfonylureas, metformin doesn't prompt insulin secretion, which helps to curb hypoglycemia risk. Metformin is beneficial in treating conditions like polycystic ovary syndrome due to its insulin-resistance reduction capability. The drug's primary action involves curtailing hepatic gluconeogenesis, a significant contributor to high blood...
988
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
Nephrotic Syndrome II : Assessment and Medical Management01:26

Nephrotic Syndrome II : Assessment and Medical Management

IntroductionNephrotic syndrome is a kidney disorder marked by excessive protein loss in the urine, leading to various systemic complications. This condition often results from damage to the glomeruli—the kidney's filtering units—causing proteinuria, low blood protein levels, and fluid retention. Understanding the assessment, diagnosis, and management of nephrotic syndrome is essential for effective treatment and prevention of further kidney damage.AssessmentPatient History: Document...
360