SGLT2 Inhibitors: Slowing of Chronic Kidney Disease Progression in Type 2 Diabetes
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REVIEW
SGLT2 Inhibitors: Slowing of Chronic Kidney Disease Progression in Type 2 Diabetes David C. Wheeler . June James . Dipesh Patel . Adie Viljoen . Amar Ali . Marc Evans . Kevin Fernando . Debbie Hicks . Nicola Milne . Philip Newland-Jones . John Wilding . as part of the Improving Diabetes Steering Committee
Received: August 3, 2020 / Accepted: September 11, 2020 Ó The Author(s) 2020
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s13300020-00930-x) contains supplementary material, which is available to authorized users.
urine albumin:creatinine ratio (ACR) is recommended during regular T2DM reviews to enable a prompt DKD diagnosis or to assess disease progression, providing an understanding of adverse risk for each individual. Many people with DKD will progress to end-stage kidney disease (ESKD), requiring renal replacement therapy (RRT), typically haemodialysis or kidney transplantation. A range of lifestyle and pharmacological interventions is recommended to help lower CV risk, slow the advancement of DKD and prevent or delay the need for RRT. Emerging evidence concerning sodium-glucose co-transporter-2 inhibitor (SGLT2i) agents suggests a role for these medicines in slowing eGFR decline, enabling regression of albuminuria and reducing progression to ESKD. Improvements in renal end
D. C. Wheeler D. Patel University College London, London, UK
D. Hicks Medicus Health Partners, Enfield, UK
J. James University Hospitals of Leicester NHS Trust, University of Leicester, Leicester, UK
N. Milne Manchester University NHS Foundation Trust, Manchester, UK
A. Viljoen Lister Hospital, Stevenage, UK
P. Newland-Jones University Hospitals Southampton NHS Foundation Trust, Southampton, UK
ABSTRACT Diabetic kidney disease (DKD) is a topic of increasing concern among clinicians involved in the management of type 2 diabetes mellitus (T2DM). It is a progressive and costly complication associated with increased risk of adverse cardiovascular (CV) and renal outcomes and mortality. Ongoing monitoring of the estimated glomerular filtration (eGFR) rate alongside the Digital Features To view digital features for this article go to https://doi.org/10.6084/m9.figshare.12937334.
A. Ali Oakenhurst Medical Practice, Blackburn, UK M. Evans University Hospital Llandough, Penarth, UK K. Fernando North Berwick Health Centre, North Berwick, UK
J. Wilding (&) University of Liverpool, Liverpool, UK e-mail: [email protected]
Diabetes Ther
points observed in SGLT2i CV outcome trials (CVOTs) highlighted the possible impact of these agents in the management of DKD. Data from the canagliflozin CREDENCE trial (Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation) have since demonstrated the effectiveness of this medicine in reducing the risk of kidney failure and CV events in a population comprising individuals with T2DM and renal disease. CREDENCE was the first SGLT2i study to examine renal outcomes as the primary end point. Realworld stu
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