PMID- 30449220 OWN - NLM STAT- MEDLINE DCOM- 20190131 LR - 20221207 IS - 1941-9260 (Electronic) IS - 0032-5481 (Linking) VI - 131 IP - 1 DP - 2019 Jan TI - Efficacy and renal outcomes of SGLT2 inhibitors in patients with type 2 diabetes and chronic kidney disease. PG - 31-42 LID - 10.1080/00325481.2019.1549459 [doi] AB - OBJECTIVE: To review glucose-lowering efficacy and changes in renal function associated with sodium-glucose co-transporter 2 (SGLT2) inhibitors among patients with chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM). DATA SOURCES: A literature search of MEDLINE and Cochrane databases was performed from 2000 to August 2018 using search terms: SGLT2 inhibitors, sodium glucose co-transporter 2, canagliflozin, empagliflozin, dapagliflozin, ertugliflozin, and chronic kidney disease. References of identified articles were also reviewed. STUDY SELECTION AND DATA EXTRACTION: English-language studies investigating glucose-lowering endpoints and/or changes in renal function with one of four U.S. approved SGLT2 inhibitors were included. A total of 10 studies met inclusion criteria and are included in this review. RESULTS: In patients with T2DM and CKD, SGLT2 inhibitors are modestly effective in lowering hemoglobin A1C and fasting plasma glucose compared to placebo. Small reductions in eGFR are seen shortly after initiating therapy with SGLT2 inhibitors, but return to baseline levels after discontinuation. SGLT2 inhibitors are associated with a substantial reduction in albuminuria and reduced risk of progression to albuminuria. CONCLUSIONS: In patients with T2DM and CKD, SGLT2 inhibitors have a decreased glucose-lowering effect compared to patients without CKD. Renal benefits among patients with CKD are similar to those without CKD and include a significant reduction in albuminuria and reduced incidence of worsening albuminuria. Given that CKD and T2DM are both associated with increased cardiovascular risk, we believe these agents should considered as preferred add-on agents in most patients with uncontrolled T2DM and eGFR >30 ml/min/1.73 m(2). Ongoing studies will provide additional information as to whether these agents should be added to the current standard of care for CKD patients, with and without T2DM. FAU - Kelly, Michael S AU - Kelly MS AD - a Department of Pharmacy Practice , Chapman University School of Pharmacy , Irvine , CA , USA. FAU - Lewis, Jelena AU - Lewis J AD - a Department of Pharmacy Practice , Chapman University School of Pharmacy , Irvine , CA , USA. FAU - Huntsberry, Ashley M AU - Huntsberry AM AD - b Department of Clinical Pharmacy , University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences , Aurora , CO , USA. FAU - Dea, Lauren AU - Dea L AD - c Pharmacy Practice Resident , Kindred Hospital , La Mirada , CA , USA. FAU - Portillo, Ivan AU - Portillo I AD - d Chapman University , Orange , CA , USA. LA - eng PT - Journal Article PT - Review DEP - 20181130 PL - England TA - Postgrad Med JT - Postgraduate medicine JID - 0401147 RN - 0 (Blood Glucose) RN - 0 (Glycated Hemoglobin A) RN - 0 (Sodium-Glucose Transporter 2 Inhibitors) SB - IM MH - Albuminuria/etiology MH - Blood Glucose/drug effects MH - Diabetes Mellitus, Type 2/complications/*drug therapy MH - Glomerular Filtration Rate/drug effects MH - Glycated Hemoglobin/drug effects MH - Humans MH - Kidney/drug effects/physiopathology MH - Renal Insufficiency, Chronic/*complications MH - Sodium-Glucose Transporter 2 Inhibitors/adverse effects/*therapeutic use MH - Treatment Outcome OTO - NOTNLM OT - SGLT2 inhibitors OT - albuminuria OT - chronic kidney disease OT - diabetes mellitus EDAT- 2018/11/20 06:00 MHDA- 2019/02/01 06:00 CRDT- 2018/11/20 06:00 PHST- 2018/11/20 06:00 [pubmed] PHST- 2019/02/01 06:00 [medline] PHST- 2018/11/20 06:00 [entrez] AID - 10.1080/00325481.2019.1549459 [doi] PST - ppublish SO - Postgrad Med. 2019 Jan;131(1):31-42. doi: 10.1080/00325481.2019.1549459. Epub 2018 Nov 30.