SGLT2 inhibitors and the kidney: Effects and mechanisms.

Department of Internal Medicine, School of Medicine, University of Ioannina, Ioannina, Greece. Department of Internal Medicine, School of Medicine, University of Crete, Crete, Greece. Electronic address: filtheo@uoc.gr.

Diabetes & metabolic syndrome. 2018;(6):1117-1123
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Abstract

AIMS: Numerous clinical trials have shown that sodium glucose cotransporter 2 (SGLT2) inhibitors exert a favorable effect on the indices of renal function (albuminuria, glomerular filtration rate decline over time) and the incidence of hard renal endpoints such as renal death or time to initiation of renal replacement therapy. MATERIALS AND METHODS In this review, we describe in detail the evidence regarding the nephroprotective mechanisms of SGLT2 inhibitors and describe the risk factors that may predispose to the development of acute kidney injury in patients receiving these drugs. RESULTS Although the impact of these drugs on renal hemodynamics seems to represent the most important renoprotective mechanism of action, many other effects of these compounds, including beneficial effects on metabolism and blood pressure, have been proposed to contribute to the observed clinical benefit. CONCLUSIONS SGLT2 inhibitors clearly act beneficially in terms of kidney function with many proposed mechanisms.

Methodological quality

Publication Type : Review

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