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
. 2023 Dec 24;9(3):526-548.
doi: 10.1016/j.ekir.2023.12.019. eCollection 2024 Mar.

The Role of Sodium-Glucose Cotransporter-2 Inhibitors in the Treatment Paradigm of CKD in Africa: An African Association of Nephrology Panel Position Paper

Faical Jarraya  1 , Abdou Niang  2 , Hussein Bagha  3 , Elliot Koranteng Tannor  4   5 , Ernest Kiswaya Sumaili  6 , Davy Ip Min Wan  7 , Mogamat-Yazied Chothia  8 , Yewondwossen Tadesse Mengistu  9 , Francois Folefack Kaze  10 , Ifeoma Isabella Ulasi  11   12 , Saraladevi Naicker  13 , Mohamed Hany Hafez  14 , Kouame Hubert Yao  15
Affiliations

The Role of Sodium-Glucose Cotransporter-2 Inhibitors in the Treatment Paradigm of CKD in Africa: An African Association of Nephrology Panel Position Paper

Faical Jarraya et al. Kidney Int Rep. .
No abstract available

Keywords: Africa; CKD management; SGLT2i; chronic kidney disease; diabetic kidney disease; sodium-glucose cotransporter-2 inhibitors.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Overall prevalence of CKD in Africa. Adapted from Stanifer JW, Jing B, Tolan S, et al. The epidemiology of chronic kidney disease in sub-Saharan Africa: a systematic review and meta-analysis. Lancet Glob Health. 2014;2(3):e174-181. doi:10.1016/S2214-109X(14)70002-6; Kaze AD, Ilori T, Jaar BG, Echouffo-Tcheugui JB. Burden of chronic kidney disease on the African continent: a systematic review and meta-analysis. BMC Nephrol. 2018;19(1):125. doi:10.1186/s12882-018-0930-5. CKD, chronic kidney disease; SSA, sub-Saharan Africa.
Figure 2
Figure 2
Identification and referral pathway for the management of CKD. ACEi, angiotensin-converting enzyme inhibitors; AKI, acute kidney injury; ARB, angiotensin receptor blockers; CKD, chronic kidney disease; CV, cardiovascular; eGFR, estimated glomerular filtration rate; GLP-1 RA, glucagon-like peptide-1 receptor agonist; HbA1c, glycosylated hemoglobin; MBD, mineral bone diseases; RAASi, renin-angiotensin aldosterone system inhibitors; SBP, systolic blood pressure; SGLT2i, sodium-glucose cotransporter-2 inhibitors; UACR, urine albumin-to-creatinine ratio. aeGFR categories in CKD classification G1: ≥90 ml/min per 1.73 m2, G2: 60–89 ml/min per 1.73 m2, G3a: 45–59 ml/min per 1.73 m2, G3b: 30–44 ml/min per 1.73 m2, G4: 15–29 ml/min per 1.73 m2 and G5: <15 ml/min per 1.73 m2 (kidney failure) bUACR categories in CKD classification A1: <30 mg/g, A2: 30–300 mg/g, A3: >300 mg/g. Recreated with permission from Shlipak MG, Tummalapalli SL, Boulware LE, et al. The case for early identification and intervention of chronic kidney disease: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference. Kidney Int. 2021;99(1):34-47. doi:10.1016/j.kint.2020.10.012; permission conveyed through Copyright Clearance Center, Inc.
Figure 3
Figure 3
Mode of action of SGLT2is and beneficial effects. eGFR, estimated glomerular filtration rate.
Figure 4
Figure 4
Delayed risk of KF with the addition of SGLT2is to RAAS blockers. Reproduced from Meraz-Muñoz AY, Weinstein J, Wald R. eGFR Decline after SGLT2 Inhibitor Initiation: The Tortoise and the Hare Reimagined. Kidney360. 2021;2(6):1042-1047. doi:10.34067/KID.0001172021. eGFR, estimated glomerular filtration rate; RAASi, renin-angiotensin aldosterone system inhibitors.
Figure 5
Figure 5
Proposed treatment algorithm for SGLT2i therapy in patients with CKD. AKI, acute kidney injury; BP, blood pressure; CKD, chronic kidney disease; DKA, diabetic ketoacidosis; eGFR, estimated glomerular filtration rate; GLP1-RA, glucagon-like peptide 1 receptor agonist; HbA1c, glycosylated Hemoglobin; RAASi, renin-angiotensin aldosterone system inhibitors; SGLT2i, sodium-glucose cotransporter-2 inhibitor; SU, sulfonylureas; UACR, urine albumin-to-creatinine ratio. ∗Refer to Box C for more details. Recreated with permission from Yau K, Dharia A, Alrowiyti I, et al. Prescribing SGLT2 Inhibitors in Patients With CKD: Expanding Indications and Practical Considerations. Kidney Int Rep. 2022;7(7):1463-1476. doi:10.1016/j.ekir.2022.04.094; permission conveyed through Copyright Clearance Center, Inc.
See this image and copyright information in PMC

References

    1. KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. https://kdigo.org/wp-content/uploads/2017/02/KDIGO_2012_CKD_GL.pdf - PubMed
    1. GBD Chronic Kidney Disease Collaboration Global, regional, and national burden of chronic kidney disease, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2020;395(10225):709–733. doi: 10.1016/S0140-6736(20)30045-3. - DOI - PMC - PubMed
    1. The top 10 causes of death. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death
    1. Jager K.J., 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. Nephrol Dial Transplant. 2019;34(11):1803–1805. doi: 10.1093/ndt/gfz174. - DOI - PubMed
    1. Jha V., Garcia-Garcia G., Iseki K., et al. Chronic kidney disease: global dimension and perspectives. Lancet. 2013;382(9888):260–272. doi: 10.1016/S0140-6736(13)60687-X. - DOI - PubMed

LinkOut - more resources