Update on the impact of sodium-glucose cotransporter inhibitors in diabetic kidney disease progression

• Autor(a) principal: Ana Carolina Cruz Afonso Romano
• Data de Publicação: 2020
• Tipo de documento: Dissertação
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://hdl.handle.net/10216/128888
• topic: Ciências médicas e da saúde; Medical and Health sciences

Introduction: Diabetic kidney disease (DKD) stands as a major cause of end-stage renal disease (ESRD). Sodium-glucose co-transporter 2 inhibitors (SGLT2i) emerged in the last years as a promising class by showing remarkable nephroprotective effects. This review focuses on the nephroprotective effects suggested in recent clinical trials, analyzes the pleiotropic mechanisms involved and discusses the possible adverse effects. Methods: This bibliographic review was based on a research in PubMed/Medline (MeSH terms: sodium-glucose cotransporter inhibitors, diabetic kidney disease, diabetic nephropathy and progression) and the research for recently conducted clinical trials that reported effects of SGLT2i on diabetic kidney disease progression. Results and Discussion: Recent clinical studies have suggested that SGLT2i class decreases the risk of diabetic kidney disease progression. Regarding long-term clinical outcomes, Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes (EMPA-REG OUTCOME), CANagliflozin cardioVascular Assessment Study (CANVAS) and Dapagliflozin Effect on CardiovascuLAR Events (DECLARE-TIMI 58) showed a 45% risk reduction in worsening of renal function , end-stage renal disease or death from renal causes. Renoprotection was also consistent across all individual outcomes. Dedicated kidney outcome trial Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation (CREDENCE) showed a 34% lower risk of developing the same renal endpoint. Conclusion: There is strong evidence suggesting that SGLT2i reduces nephropathy progression in individuals with type 2 diabetes. The data presented in this review supports the use of this pharmacological class in order to delay diabetic kidney disease progression.