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SGLT-2 inhibitors in diabetes: a focus on renoprotection

Revista da Associacao Medica Brasileira (1992), 2020-01, Vol.66Suppl 1 (Suppl 1), p.s17-s24 [Peer Reviewed Journal]

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. ;ISSN: 0104-4230 ;ISSN: 1806-9282 ;EISSN: 1806-9282 ;DOI: 10.1590/1806-9282.66.S1.17 ;PMID: 31939531

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Title:
SGLT-2 inhibitors in diabetes: a focus on renoprotection
Author: Gonzalez, Diego Ennes ; Foresto, Renato Demarchi ; Ribeiro, Artur Beltrame
Subjects: Benzhydryl Compounds - therapeutic use ; Canagliflozin - therapeutic use ; Cardiovascular Diseases - etiology ; Cardiovascular Diseases - mortality ; Cardiovascular Diseases - prevention & control ; Diabetes Mellitus, Type 2 - complications ; Diabetes Mellitus, Type 2 - drug therapy ; Diabetic Nephropathies - etiology ; Diabetic Nephropathies - metabolism ; Diabetic Nephropathies - prevention & control ; Glomerular Filtration Rate ; Glucose - metabolism ; Glucosides - therapeutic use ; Humans ; Hypoglycemic Agents - pharmacology ; Hypoglycemic Agents - therapeutic use ; Kidney - drug effects ; Kidney - metabolism ; Kidney - physiopathology ; Kidney Diseases - etiology ; Kidney Diseases - metabolism ; Kidney Diseases - prevention & control ; MEDICINE, GENERAL & INTERNAL ; Sodium-Glucose Transporter 2 - pharmacology ; Sodium-Glucose Transporter 2 - therapeutic use ; Sodium-Glucose Transporter 2 Inhibitors - pharmacology ; Sodium-Glucose Transporter 2 Inhibitors - therapeutic use
Is Part Of: Revista da Associacao Medica Brasileira (1992), 2020-01, Vol.66Suppl 1 (Suppl 1), p.s17-s24
Description: Type 2 diabetes mellitus is an important public health problem, with a significant impact on cardiovascular morbidity and mortality and an important risk factor for chronic kidney disease. Various hypoglycemic therapies have proved to be beneficial to clinical outcomes, while others have failed to provide an improvement in cardiovascular and renal failure, only reducing blood glucose levels. Recently, sodium-glucose cotransporter-2 (SGLT2) inhibitors, represented by the empagliflozin, dapagliflozin, and canagliflozin, have been showing satisfactory and strong results in several clinical trials, especially regarding the reduction of cardiovascular mortality, reduction of hospitalization due to heart failure, reduction of albuminuria, and long-term maintenance of the glomerular filtration rate. The benefit from SGLT2 inhibitors stems from its main mechanism of action, which occurs in the proximal tubule of the nephron, causing glycosuria, and a consequent increase in natriuresis. This leads to increased sodium intake by the juxtaglomerular apparatus, activating the tubule glomerular-feedback and, finally, reducing intraglomerular hypertension, a frequent physiopathological condition in kidney disease caused by diabetes. In addition, this class of medication presents an appropriate safety profile, and its most frequently reported complication is an increase in the incidence of genital infections. Thus, these hypoglycemic agents gained space in practical recommendations for the management of type 2 diabetes mellitus and should be part of the initial therapeutic approach to provide, in addition to glycemic control, cardiovascular outcomes, and the renoprotection in the long term.
Publisher: Brazil: Associação Médica Brasileira
Language: English;Portuguese
Identifier: ISSN: 0104-4230
ISSN: 1806-9282
EISSN: 1806-9282
DOI: 10.1590/1806-9282.66.S1.17
PMID: 31939531
Source: SciELO

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SGLT-2 inhibitors in diabetes: a focus on renoprotection

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. ;ISSN: 0104-4230 ;ISSN: 1806-9282 ;EISSN: 1806-9282 ;DOI: 10.1590/1806-9282.66.S1.17 ;PMID: 31939531

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