Kidney and cardiovascular protection with SGLT2 inhibitors: lessons from cardiovascular outcome trials and CREDENCE

J Nephrol. 2020 Oct;33(5):977-983. doi: 10.1007/s40620-020-00809-x. Epub 2020 Jul 28.

Abstract

The burden of diabetic kidney disease is rising rapidly worldwide, and new therapies are of vital importance to reduce the risk of kidney failure and major cardiovascular events. Of the newer glucose-lowering agents, sodium-glucose co-transporter 2 (SGLT2) inhibitors have shown exciting potential in preventing these adverse events. The results of several large cardiovascular outcome trials, a single dedicated kidney outcome trial and a dedicated heart failure trial, demonstrate substantial clinical benefits for several different SGLT2 inhibitors. Emerging evidence raises the possibility that these benefits may extend to those with non-diabetic chronic kidney disease. This review summarises the current evidence for SGLT2 inhibitor benefits and harms, and examines which patients are most likely to gain from these therapies.

Keywords: Chronic kidney disease; Clinical outcomes; SGLT2 inhibitors; Type 2 diabetes.

Publication types

  • Review

MeSH terms

  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / drug therapy
  • Diabetic Nephropathies* / drug therapy
  • Diabetic Nephropathies* / prevention & control
  • Humans
  • Kidney
  • Sodium-Glucose Transporter 2
  • Sodium-Glucose Transporter 2 Inhibitors* / adverse effects

Substances

  • Sodium-Glucose Transporter 2
  • Sodium-Glucose Transporter 2 Inhibitors