Sodium-Glucose Cotransporter 2 Inhibitors in Diabetic Kidney Disease and beyond.

Glomerular diseases Pub Date : 2025-01-23 eCollection Date: 2025-01-01 DOI:10.1159/000543685
Zein Alabdin Hannouneh, C Elena Cervantes, Mohamad Hanouneh, Mohamed G Atta
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Abstract

Background: Sodium-glucose cotransporter 2 inhibitors (SGLT2is) have significantly impacted the management of diabetic kidney disease (DKD) and heart failure (HF), providing benefits beyond glycemic control. This review examines the mechanisms through which SGLT2is provide renal and cardiovascular protection and assesses their clinical efficacy.

Summary: By inducing glucosuria and natriuresis, SGLT2is alleviate multiple complications induced by chronic hyperglycemia. Moreover, SGLT2is reduce albuminuria, improve tubular function, and modulate erythropoiesis. Additionally, they mitigate inflammation and fibrosis by decreasing oxidative stress and downregulating proinflammatory pathways. Clinical trials have demonstrated significant reductions in renal and cardiovascular events among patients with type 2 diabetes mellitus. A comprehensive review of the literature was conducted through PubMed, highlighting the effects of SGLT2is and the results of major clinical trials involving SGLT2is.

Key messages: SGLT2is play a crucial role in the management of DKD and HF by addressing multiple pathogenic pathways. Currently, SGLT2is are included in clinical guidelines for DKD and HF management, and their benefits extend to nondiabetic populations. Further research is needed to explore SGLT2is' multifaceted mechanisms and potential applications across diverse patient populations and different disease etiologies.

钠-葡萄糖共转运蛋白2抑制剂在糖尿病肾病及其他疾病中的作用
背景:钠-葡萄糖共转运蛋白2抑制剂(SGLT2is)对糖尿病肾病(DKD)和心力衰竭(HF)的治疗有显著影响,其益处不仅限于血糖控制。这篇综述探讨了SGLT2is提供肾脏和心血管保护的机制,并评估了它们的临床疗效。摘要:SGLT2is通过诱导血糖和尿钠,减轻慢性高血糖引起的多种并发症。此外,SGLT2is减少蛋白尿,改善小管功能,调节红细胞生成。此外,它们通过降低氧化应激和下调促炎途径来减轻炎症和纤维化。临床试验表明,2型糖尿病患者的肾脏和心血管事件显著减少。通过PubMed对相关文献进行了全面的回顾,强调了SGLT2is的作用以及涉及SGLT2is的主要临床试验的结果。关键信息:SGLT2is通过解决多种致病途径,在DKD和HF的管理中发挥关键作用。目前,SGLT2is被纳入DKD和HF管理的临床指南,其益处扩展到非糖尿病人群。需要进一步的研究来探索SGLT2is的多方面机制和在不同患者群体和不同病因中的潜在应用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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