Efficacy and renal outcomes of SGLT2 inhibitors in patients with type 2 diabetes and chronic kidney disease
| Autor: | Lauren Dea, Ivan Portillo, Ashley M Huntsberry, Jelena Lewis, Michael S. Kelly |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Blood Glucose
medicine.medical_specialty Renal function 030209 endocrinology & metabolism Type 2 diabetes 030204 cardiovascular system & hematology Kidney 03 medical and health sciences 0302 clinical medicine Internal medicine Diabetes mellitus medicine Albuminuria Humans In patient Renal Insufficiency Chronic Sodium-Glucose Transporter 2 Inhibitors Glycated Hemoglobin business.industry General Medicine medicine.disease Treatment Outcome Diabetes Mellitus Type 2 sense organs medicine.symptom business Glomerular Filtration Rate Kidney disease |
| Zdroj: | Postgraduate Medicine. 131:31-42 |
| ISSN: | 1941-9260 0032-5481 |
| DOI: | 10.1080/00325481.2019.1549459 |
| Popis: | To review glucose-lowering efficacy and changes in renal function associated with sodium-glucose co-transporter 2 (SGLT2) inhibitors among patients with chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM).A literature search of MEDLINE and Cochrane databases was performed from 2000 to August 2018 using search terms: SGLT2 inhibitors, sodium glucose co-transporter 2, canagliflozin, empagliflozin, dapagliflozin, ertugliflozin, and chronic kidney disease. References of identified articles were also reviewed.English-language studies investigating glucose-lowering endpoints and/or changes in renal function with one of four U.S. approved SGLT2 inhibitors were included. A total of 10 studies met inclusion criteria and are included in this review.In patients with T2DM and CKD, SGLT2 inhibitors are modestly effective in lowering hemoglobin A1C and fasting plasma glucose compared to placebo. Small reductions in eGFR are seen shortly after initiating therapy with SGLT2 inhibitors, but return to baseline levels after discontinuation. SGLT2 inhibitors are associated with a substantial reduction in albuminuria and reduced risk of progression to albuminuria.In patients with T2DM and CKD, SGLT2 inhibitors have a decreased glucose-lowering effect compared to patients without CKD. Renal benefits among patients with CKD are similar to those without CKD and include a significant reduction in albuminuria and reduced incidence of worsening albuminuria. Given that CKD and T2DM are both associated with increased cardiovascular risk, we believe these agents should considered as preferred add-on agents in most patients with uncontrolled T2DM and eGFR30 ml/min/1.73 m |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|