Author:
Granata Antonio,Pesce Francesco,Iacoviello Massimo,Anzaldi Massimiliano,Amico Francesco,Catalano Maria,Leonardi Giuseppe,Gatta Carmela,Costanza Giusy,Corrao Salvatore,Gesualdo Loreto
Abstract
Since their introduction as antidiabetic drugs, SGLT2 inhibitors (SGLT2i) have come a long way, proving to be beneficial on cardiovascular and renal outcomes independently of diabetes status. The benefits go far beyond glycemic control, and both the cardio- and nephroprotection are underpinned by diverse mechanisms. From the activation of tubule glomerular feedback and the consequent reduction in hyperfiltration to the improvement of hypoxia and oxidative stress in the renal cortex, SGLT2i have also been shown to inhibit hepcidin and limit podocyte damage. Likewise, they improve cardiac metabolism and bioenergetics, and reduce necrosis and cardiac fibrosis and the production of adipokines, cytokines, and epicardial adipose tissue mass. In terms of outcomes, the efficacy has been demonstrated on blood pressure control, BMI, albuminuria, stroke, heart disease, and mortality rate due to cardiovascular events. Patients with chronic kidney disease and proteinuria, with or without diabetes, treated with some SGLT2i have a reduced risk of progression. The analysis of subgroups of individuals with specific diseases such as IgA nephropathy has confirmed this solid effect on renal outcomes. Given these overarching activities on such a broad pathophysiological background and the favorable safety profile that goes with the use of SGLT2i, it is now certain that they are changing our approach to clinical interventions for important outcomes with an impressive impact.
Reference98 articles.
1. Diabetic Kidney Disease: Challenges, Progress, and Possibilities;Alicic;Clin J Am Soc Nephrol,2017
2. Global and Regional Mortality From 235 Causes of Death for 20 Age Groups in 1990 and 2010: A Systematic Analysis for the Global Burden of Disease Study 2010 [Published Correction Appears in Lancet;Lozano,2013
3. Risk Factors and Chronic Kidney Disease;Taal,2015
4. Renal Lesions Predict Progression of Diabetic Nephropathy in Type 1 Diabetes;Caramori;J Am Soc Nephrol,2013
5. Thickness of Glomerular and Tubular Basement Membranes in Preclinical and Clinical Stages of Diabetic Nephropathy;Tyagi;Indian J Nephrol,2008
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