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Review
. 2023 Feb:242:108330.
doi: 10.1016/j.pharmthera.2022.108330. Epub 2022 Dec 10.

Sodium-glucose co-transporter 2 inhibitors in patients with chronic kidney disease

Joshua Solomon  1 , Maria Carolina Festa  1 , Yiannis S Chatzizisis  2 , Ratna Samanta  3 , Rita S Suri  4 , Thomas A Mavrakanas  5
Affiliations
Review

Sodium-glucose co-transporter 2 inhibitors in patients with chronic kidney disease

Joshua Solomon et al. Pharmacol Ther. 2023 Feb.

Abstract

Diabetes drives an increasing burden of cardiovascular and renal disease worldwide, motivating the search for new hypoglycemic agents that confer cardiac and renal protective effects. Although initially developed as hypoglycemic agents, sodium-glucose co-transporter 2 (SGLT-2) inhibitors have since been studied in patients with and without diabetes for the management of heart failure and chronic kidney disease. A growing body of evidence supports the efficacy and safety of SGLT-2 inhibitors in patients with chronic kidney disease (CKD), based on complex mechanisms of action that extend far beyond glucosuria and that confer beneficial effects on cardiovascular and renal hemodynamics, fibrosis, inflammation, and end-organ protection. This review focuses on the pharmacology and pathophysiology of SGLT-2 inhibitors in patients with CKD, as well as their cardiovascular and renal effects in this population. We are focusing on the five agents that have been tested in cardiovascular outcome trials and that have been approved either in Europe or in North America: empagliflozin, dapagliflozin, canagliflozin, ertugliglozin, and sotagliflozin.

Keywords: Albuminuria; Canagliflozin; Cardiovascular events; Chronic kidney disease; Dapagliflozin; Empagliflozin; Ertugliflozin; Progression; Sodium-glucose co-transporter 2 inhibitors; Sotagliflozin.

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Conflict of interest statement

Conflicts of interest Drs. Solomon and Festa have nothing to disclose. Dr. Chatzizisis received honoraria from Boston Scientific, has served on advisory boards for Boston Scientific and Medtronic, and has received research grants from Boston Scientific and Medtronic outside the submitted work. Dr. Samanta has served on advisory boards for GSK and Novartis and has received research grants from Amgen outside the submitted work. Dr. Suri has served on advisory boards for Otsuka, Bayer, GSK, and Amgen outside the submitted work. Dr. Mavrakanas received speaker honoraria from Daiichi Sankyo, BMS Canada, Janssen, Astra Zeneca, and Pfizer and has served on advisory boards for Boehringer Ingelheim, Bayer, GSK, and Servier Canada outside the submitted work. He has also received an unrestricted research grant from Astra Zeneca.

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