Sodium-glucose cotransporter 2 inhibition : towards an indication to treat diabetic kidney disease
Górriz, Jose Luis (Red de Investigación Renal (REDINREN))
Navarro-González, Juan F. (Universidad de La Laguna. Instituto de Tecnologías Biomédicas)
Ortiz, Alberto (Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz)
Vergara, Ander (Hospital Universitari Vall d'Hebron)
Núñez, Julio (Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares)
Jacobs-Cachá, Conxita (Hospital Universitari Vall d'Hebron)
Martínez-Castelao, Alberto (Hospital Universitari de Bellvitge)
Soler, María José (Hospital Universitari Vall d'Hebron)
Universitat Autònoma de Barcelona

Data:	2020
Resum:	Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have clearly demonstrated their beneficial effect in diabetic kidney disease (DKD) on top of the standard of care [blood glucose control, renin-angiotensin system blockade, smoking cessation and blood pressure (BP) control], even in patients with overt DKD. However, the indication of this drug class is still blood glucose lowering in type 2 diabetic patients with estimated glomerular filtration rate >45 mL/min/1. 73 m 2. Based on the new evidence, several scientific societies have emphasized the preferential prescription of SGLT2i for patients at risk of heart failure or kidney disease, but still within the limits set by health authorities. A rapid positioning of both the European Medicines Agency and the US Food and Drug Administration will allow patients with overt DKD to benefit from SGLT2i. Clinical experience suggests that SGLT2i safety management may in part mirror renin-angiotensin blockade safety management in patients with overt DKD. This review focuses on the rationale for an indication of SGTL2i in DKD. We further propose clinical steps for maximizing the safety of SGLT2i in DKD patients on other antidiabetic, BP or diuretic medication.
Ajuts:	Instituto de Salud Carlos III PI16-02057 Instituto de Salud Carlos III PI17-00257 Instituto de Salud Carlos III RD016-0009
Nota:	Altres ajuts: Comunidad de Madrid en Biomedicina B2017/BMD-3686 CIFRA2-CM, and CIBER CV16/11/00420
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article de revisió ; Article ; Versió publicada
Matèria:	Chronic renal failure ; Diabetic kidney disease ; ESRD ; SGLT2 inhibitors ; Type 2 diabetes
Publicat a:	Nephrology Dialysis Transplantation, Vol. 35 (January 2020) , p. i13-i23, ISSN 1460-2385

DOI: 10.1093/ndt/gfz237
PMID: 32003834

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