Review of SGLT2i for the Treatment of Renal Complications: Experience in Patients with and Without T2D

The management of type 2 diabetes (T2D) involves decreasing plasma glucose levels and reducing cardiovascular and microvascular complications. Diabetic kidney disease (DKD), defined as presence of albuminuria, impaired glomerular filtration, or both, is an insidious microvascular complication of dia...

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Autores: González Albarrán, Olga, Morales, Cristóbal, Pérez Maraver, Manuel, Aparicio Sánchez, José Juan, Simó, Rafael
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2022
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/187383
Acceso en línea:https://hdl.handle.net/2445/187383
Access Level:acceso abierto
Palabra clave:Malalties del ronyó
Diabetis
Kidney diseases
Diabetes
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spelling Review of SGLT2i for the Treatment of Renal Complications: Experience in Patients with and Without T2DGonzález Albarrán, OlgaMorales, CristóbalPérez Maraver, ManuelAparicio Sánchez, José JuanSimó, RafaelMalalties del ronyóDiabetisKidney diseasesDiabetesThe management of type 2 diabetes (T2D) involves decreasing plasma glucose levels and reducing cardiovascular and microvascular complications. Diabetic kidney disease (DKD), defined as presence of albuminuria, impaired glomerular filtration, or both, is an insidious microvascular complication of diabetes that generates a substantial personal and clinical burden. The progressive reduction in renal function and increased albuminuria results in an increase of cardiovascular events. Thus, patients with DKD require exhaustive control of the associated cardiovascular risk factors. People with diabetes and renal impairment have fewer options of antidiabetic drugs because of contraindications, adverse effects, or altered pharmacokinetics. Sodium-glucose cotransporter type 2 inhibitors (SGLT2i) reduce blood glucose concentrations by blocking the uptake of sodium and glucose in the proximal tubule and promoting glycosuria, and these agents now have an important role in the management of T2D. The results of several cardiovascular outcomes trials suggested that SGLT2i are associated with improvements in renal endpoints in addition to their reduction in cardiovascular events and mortality, which represents a major advance in the care of this population. The dedicated kidney outcomes trials have confirmed the renoprotective action of SGLT2i across different glomerular filtration and albuminuria values, even in patients with non-diabetic chronic kidney disease. Notably, this improvement in kidney function may indirectly benefit cardiac function through multifaceted interorgan cross talk, which can break the cardiorenal vicious circle linked to T2D. In this article, we briefly review the different mechanisms of action that may explain the renal beneficial effects of SGLT2i and disclose the results of the key renal outcome trials and the subsequent update of related clinical guidelines.Springer Science2022info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/187383Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció del document publicat a: https://doi.org/10.1007/s13300-022-01276-2Diabetes Therapy, 2022, vol. 13, num. 1, p. 35-49https://doi.org/10.1007/s13300-022-01276-2cc by-nc (c) González Albarrán, Olga et al, 2022http://creativecommons.org/licenses/by-nc/3.0/es/info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/1873832026-05-27T06:46:51Z
dc.title.none.fl_str_mv Review of SGLT2i for the Treatment of Renal Complications: Experience in Patients with and Without T2D
title Review of SGLT2i for the Treatment of Renal Complications: Experience in Patients with and Without T2D
spellingShingle Review of SGLT2i for the Treatment of Renal Complications: Experience in Patients with and Without T2D
González Albarrán, Olga
Malalties del ronyó
Diabetis
Kidney diseases
Diabetes
title_short Review of SGLT2i for the Treatment of Renal Complications: Experience in Patients with and Without T2D
title_full Review of SGLT2i for the Treatment of Renal Complications: Experience in Patients with and Without T2D
title_fullStr Review of SGLT2i for the Treatment of Renal Complications: Experience in Patients with and Without T2D
title_full_unstemmed Review of SGLT2i for the Treatment of Renal Complications: Experience in Patients with and Without T2D
title_sort Review of SGLT2i for the Treatment of Renal Complications: Experience in Patients with and Without T2D
dc.creator.none.fl_str_mv González Albarrán, Olga
Morales, Cristóbal
Pérez Maraver, Manuel
Aparicio Sánchez, José Juan
Simó, Rafael
author González Albarrán, Olga
author_facet González Albarrán, Olga
Morales, Cristóbal
Pérez Maraver, Manuel
Aparicio Sánchez, José Juan
Simó, Rafael
author_role author
author2 Morales, Cristóbal
Pérez Maraver, Manuel
Aparicio Sánchez, José Juan
Simó, Rafael
author2_role author
author
author
author
dc.subject.none.fl_str_mv Malalties del ronyó
Diabetis
Kidney diseases
Diabetes
topic Malalties del ronyó
Diabetis
Kidney diseases
Diabetes
description The management of type 2 diabetes (T2D) involves decreasing plasma glucose levels and reducing cardiovascular and microvascular complications. Diabetic kidney disease (DKD), defined as presence of albuminuria, impaired glomerular filtration, or both, is an insidious microvascular complication of diabetes that generates a substantial personal and clinical burden. The progressive reduction in renal function and increased albuminuria results in an increase of cardiovascular events. Thus, patients with DKD require exhaustive control of the associated cardiovascular risk factors. People with diabetes and renal impairment have fewer options of antidiabetic drugs because of contraindications, adverse effects, or altered pharmacokinetics. Sodium-glucose cotransporter type 2 inhibitors (SGLT2i) reduce blood glucose concentrations by blocking the uptake of sodium and glucose in the proximal tubule and promoting glycosuria, and these agents now have an important role in the management of T2D. The results of several cardiovascular outcomes trials suggested that SGLT2i are associated with improvements in renal endpoints in addition to their reduction in cardiovascular events and mortality, which represents a major advance in the care of this population. The dedicated kidney outcomes trials have confirmed the renoprotective action of SGLT2i across different glomerular filtration and albuminuria values, even in patients with non-diabetic chronic kidney disease. Notably, this improvement in kidney function may indirectly benefit cardiac function through multifaceted interorgan cross talk, which can break the cardiorenal vicious circle linked to T2D. In this article, we briefly review the different mechanisms of action that may explain the renal beneficial effects of SGLT2i and disclose the results of the key renal outcome trials and the subsequent update of related clinical guidelines.
publishDate 2022
dc.date.none.fl_str_mv 2022
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/187383
url https://hdl.handle.net/2445/187383
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1007/s13300-022-01276-2
Diabetes Therapy, 2022, vol. 13, num. 1, p. 35-49
https://doi.org/10.1007/s13300-022-01276-2
dc.rights.none.fl_str_mv cc by-nc (c) González Albarrán, Olga et al, 2022
http://creativecommons.org/licenses/by-nc/3.0/es/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc by-nc (c) González Albarrán, Olga et al, 2022
http://creativecommons.org/licenses/by-nc/3.0/es/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Springer Science
publisher.none.fl_str_mv Springer Science
dc.source.none.fl_str_mv Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.301603

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