title: Sodium-glucose linked transporter-2 inhibitors in chronic kidney disease.
abstract: SGLT2 inhibitors are new antihyperglycaemic agents whose ability to lower glucose is directly proportional to GFR. Therefore, in chronic kidney disease (CKD) the blood glucose lowering effect is reduced. Unlike many current therapies, the mechanism of action of SGLT2 inhibitors is independent of insulin action or beta-cell function. In addition, the mechanism of action of SGLT2 inhibitors is complementary and not alternative to other antidiabetic agents. SGLT2 inhibitors could be potentially effective in attenuating renal hyperfiltration and, consequently, the progression of CKD. Moreover, the reductions in intraglomerular pressure, systemic blood pressure, and uric acid levels induced by SGLT inhibition may potentially be of benefit in CKD subjects without diabetes. However, at present, only few clinical studies were designed to evaluate the effects of SGLT2 inhibitors in CKD. Consequently, safety and potential efficacy beyond blood glucose lowering should be better clarified in CKD. In this paper we provide an updated review of the use of SGLT2 inhibitors in clinical practice, with particular attention on subjects with CKD.
authors.affiliation: Department of Internal Medicine, University of Catania, 95100 Catania, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Zanoli
authors.affiliation: Department of Nephrology, Presidio Ospedaliero Agrigento, 92100 Agrigento, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Granata
authors.affiliation: Department of Nephrology, San Bassiano Hospital, 36061 Bassano del Grappa, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Lentini
authors.affiliation: Department of Internal Medicine, University of Catania, 95100 Catania, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Rastelli
authors.affiliation: Department of Internal Medicine, University of Catania, 95100 Catania, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Fatuzzo
authors.affiliation: Department of Internal Medicine, University of Catania, 95100 Catania, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Rapisarda
authors.affiliation: Department of Internal Medicine, University of Catania, 95100 Catania, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Castellino
mesh_terms: D000818:Animals; D000068896:Canagliflozin / Q000009:adverse effects / Q000627:therapeutic use; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000503:physiopathology; D003928:Diabetic Nephropathies / Q000188:drug therapy / Q000503:physiopathology; D005919:Glomerular Filtration Rate; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D051436:Renal Insufficiency, Chronic / Q000188:drug therapy* / Q000503:physiopathology; D051297:Sodium-Glucose Transporter 2; D000077203:Sodium-Glucose Transporter 2 Inhibitors; D013012:Sorbitol / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D000068896:Canagliflozin; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D051297:Sodium-Glucose Transporter 2; D000077203:Sodium-Glucose Transporter 2 Inhibitors; D013012:Sorbitol; C089180:SLC5A2 protein, human; C517652:hemoglobin A1c protein, human; C549343:1,5-anhydro-1-(5-(4-ethoxybenzyl)-2-methoxy-4-methylphenyl)-1-thioglucitol