Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Jul;35(6):1605-1618.
doi: 10.1007/s40620-022-01336-7. Epub 2022 May 18.

Can SGLT2 inhibitors answer unmet therapeutic needs in chronic kidney disease?

Luca De Nicola  1 , Mario Cozzolino  2 , Simonetta Genovesi  3   4 , Loreto Gesualdo  5 , Giuseppe Grandaliano  6   7 , Roberto Pontremoli  8
Affiliations
Review

Can SGLT2 inhibitors answer unmet therapeutic needs in chronic kidney disease?

Luca De Nicola et al. J Nephrol. 2022 Jul.

Abstract

Chronic kidney disease (CKD) is a global health problem, affecting more than 850 million people worldwide. The number of patients receiving renal replacement therapy (dialysis or renal transplantation) has increased over the years, and it has been estimated that the number of people receiving renal replacement therapy will more than double from 2.618 million in 2010 to 5.439 million in 2030, with wide differences among countries. The main focus of CKD treatment has now become preserving renal function rather than replacing it. This is possible, at least to some extent, through the optimal use of multifactorial therapy aimed at preventing end-stage kidney disease and cardiovascular events. Sodium/glucose cotransporter 2 inhibitors (SGLT2i) reduce glomerular hypertension and albuminuria with beneficial effects on progression of renal damage in both diabetic and non-diabetic CKD. SGLT2 inhibitors also show great benefits in cardiovascular protection, irrespective of diabetes. Therefore, the use of these drugs will likely be extended to the whole CKD population as a new standard of care.

Keywords: CDK; Diabetes; ESKD; SGLT2i.

PubMed Disclaimer

Conflict of interest statement

MC has served as a Lecturer for AstraZeneca; LDN has served as a consultant and/or lecturer for Astellas, AstraZeneca, Mundipharma, Novo Nordisk; SG has received speaker fees from Astra Zeneca, Boehringer-Ingelheim; LG has provided research support for Abionyx, Sanofi, has served as a speaker for Fresenius, Estor, Werfen, Astellas, AstraZeneca, Travere and as a consultant for Sandoz, Sanofi, Baxter, Mundipharma, Estor, Pharmadoc, Retrophin, Travere, AstraZeneca, GSK, Novartis, Chinook; GG has no conflict of interests; RP has received speaker fees from Astra Zeneca, Boehringer-Ingelheim, Menarini, Eli-Lilly, MSD, Novo Nordisk, Alfasigma.

Figures

Fig. 1
Fig. 1
Kidney-preserving care. BP blood pressure, MR mineralocorticoid receptor, RAAS renin–angiotensin–aldosterone system, SGLT2 sodium/glucose cotransporter 2. Adapted from [44]
Fig. 2
Fig. 2
Hyperfiltration as a major determinant of CKD progression: role of SGLT2i. Hyperfiltration in the absence of (A) or during (B) treatment with SGLT2i. Adapted from [47]
See this image and copyright information in PMC

References

    1. Jager KJ, Kovesdy C, Langham R, Rosenberg M, Jha V, Zoccali C. A single number for advocacy and communication-worldwide more than 850 million individuals have kidney diseases. Kidney Int. 2019;96(5):1048–1050. doi: 10.1016/j.kint.2019.07.012. - DOI - PubMed
    1. GBD 2017 Disease and Injury Incidence and Prevalence Collaborators Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392:1789–1858. doi: 10.1016/S0140-6736(18)32279-7. - DOI - PMC - PubMed
    1. Liyanage T, Ninomiya T, Jha V, et al. Worldwide access to treatment for end-stage kidney disease: a systematic review. Lancet. 2015;385(9981):1975–1982. doi: 10.1016/S0140-6736(14)61601-9. - DOI - PubMed
    1. Luyckx VA, Cherney DZI, Bello AK. Preventing CKD in developed countries [published correction appears in Kidney Int Rep 2020;5(5):758] Kidney Int Rep. 2019;5(3):263–277. doi: 10.1016/j.ekir.2019.12.003. - DOI - PMC - PubMed
    1. Xie Y, Bowe B, Mokdad AH, et al. Analysis of the Global Burden of Disease study highlights the global, regional, and national trends of chronic kidney disease epidemiology from 1990 to 2016. Kidney Int. 2018;94(3):567–581. doi: 10.1016/j.kint.2018.04.011. - DOI - PubMed

MeSH terms

Substances