We are analyzing https://link.springer.com/article/10.1007/s40265-021-01573-3.

Title:
A Role for SGLT-2 Inhibitors in Treating Non-diabetic Chronic Kidney Disease | Drugs
Description:
In recent years, inhibitors of the sodium-glucose co-transporter 2 (SGLT2 inhibitors) have been shown to have significant protective effects on the kidney and the cardiovascular system in patients with diabetes. This effect is also manifested in chronic kidney disease (CKD) patients and is minimally due to improved glycaemic control. Starting from these positive findings, SGLT2 inhibitors have also been tested in patients with non-diabetic CKD or heart failure with reduced ejection fraction. Recently, the DAPA-CKD trial showed a significantly lower risk of CKD progression or death from renal or cardiovascular causes in a mixed population of patients with diabetic and non-diabetic CKD receiving dapagliflozin in comparison with placebo. In patients with heart failure and reduced ejection fraction, two trials (EMPEROR-Reduced and DAPA-HF) also found a significantly lower risk of reaching the secondary renal endpoint in those treated with an SGLT2 inhibitor in comparison with placebo. This also applied to patients with CKD. Apart from their direct mechanism of action, SGLT2 inhibitors have additional effects that could be of particular interest for patients with non-diabetic CKD. Among these, SGLT2 inhibitors reduce blood pressure and serum acid uric levels and can increase hemoglobin levels. Some safety issues should be further explored in the CKD population. SGLT2 inhibitors can minimally increase potassium levels, but this has not been shown by the CREDENCE trial. They also increase magnesium and phosphate reabsorption. These effects could become more significant in patients with advanced CKD and will need monitoring when these agents are used more extensively in the CKD population. Conversely, they do not seem to increase the risk of acute kidney injury.
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Keywords {🔍}

pubmed, article, google, scholar, cas, diabetes, kidney, central, patients, renal, sglt, disease, inhibitors, cotransporter, type, chronic, effects, cardiovascular, physiol, glucose, med, sodiumglucose, heart, metaanalysis, trial, outcomes, dapagliflozin, inhibition, engl, inhibitor, analysis, effect, diabetic, nephrol, sodium, study, randomized, canagliflozin, metab, failure, investigators, trials, mellitus, int, clin, empagliflozin, review, ckd, systematic, events,

Topics {✒️}

eu/en/documents/referral/restriction-combined medicines-affecting-renin-angiotensin-system-ras_en il-1β-mediated mcp-1/ccl2 end-stage kidney disease suppressing tgf-beta/smad signaling stimulating ampk-akt-enos pathway month download article/chapter kidney diseases hypoxia-inducible factor-2alpha hypoxia-inducible factor isoforms hypoxia-inducible factor-1α renin-angiotensin-aldosterone system renin-angiotensin system blockers amp-activated protein kinase 52-week open-label study sugar/polyol transport facilitators glucose-dependent incretin secretion upregulating hif-1a levels wright jt jr intensive blood-pressure control angiotensin ii-dependent hypertension renin-angiotensin system inhibitors lucia del vecchio cardiorenal end points diet-induced obese mice placebo-controlled sacra study halt-pkd trial investigators renal anti-fibrotic effect double-blind red trial chronic kidney disease de jong pe dapa-ckd trial showed dapa-ckd trial committees dapa-ckd trial demonstrates empa-reg outcome investigators silvia peiti renin-angiotensin system article drugs aims full article pdf chronic renal disease patient-level meta-analysis bmc endocr disord article received goff dc jr early proximal tubule bayesian network meta-analysis van ballegooijen aj diabetic kidney disease placebo-controlled randomized trials randomized placebo-controlled trials

Questions {❓}

Alkali supplementation as a therapeutic in chronic kidney disease: what mediates protection?
Combined neprilysin and RAS inhibition for the failing heart: Straining the kidney to help the heart?
Effects of SGLT2 inhibition in human kidney proximal tubular cells–renoprotection in diabetic nephropathy?
Is it the agent or the blood pressure level that matters for renal and vascular protection in chronic nephropathies?
Magnesium in chronic kidney disease: should we care?
Magnesium to prevent kidney disease-associated vascular calcification: crystal clear?

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