PMID- 31583087
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201001
IS  - 2048-8505 (Print)
IS  - 2048-8513 (Electronic)
IS  - 2048-8505 (Linking)
VI  - 12
IP  - 5
DP  - 2019 Oct
TI  - Sodium-glucose cotransporter 2 inhibitors for diabetic kidney disease: a primer 
      for deprescribing.
PG  - 620-628
LID - 10.1093/ckj/sfz100 [doi]
AB  - Chronic kidney disease (CKD) is a critical global public health problem 
      associated with high morbidity and mortality, poorer quality of life and 
      increased health care expenditures. CKD and its associated comorbidities are one 
      of the most complex clinical constellations to manage. Treatments for CKD and its 
      comorbidities lead to polypharmacy, which exponentiates the morbidity and 
      mortality. Sodium-glucose cotransporter 2 inhibitors (SGLT2is) have shown 
      remarkable benefits in cardiovascular and renal protection in patients with type 
      2 diabetes mellitus (T2DM). The pleiotropic effects of SGLT2is beyond glycosuria 
      suggest a promising role in reducing polypharmacy in diabetic CKD, but the 
      potential adverse effects of SGLT2is should also be considered. In this review, 
      we present a typical case of a patient with multiple comorbidities seen in a CKD 
      clinic, highlighting the polypharmacy and complexity in the management of 
      proteinuria, hyperkalemia, volume overload, hyperuricemia, hypoglycemia and 
      obesity. We review the cardiovascular and renal protection effects of SGLT2is in 
      the context of clinical trials and current guidelines. We then discuss the roles 
      of SGLT2is in the management of associated comorbidities and review the adverse 
      effects and controversies of SGLT2is. We conclude with a proposal for 
      deprescribing principles when initiating SGLT2is in patients with diabetic CKD.
CI  - (c) The Author(s) 2019. Published by Oxford University Press on behalf of ERA-EDTA.
FAU - Li, Jiahua
AU  - Li J
AUID- ORCID: 0000-0003-1342-3945
AD  - Renal Division, Department of Medicine, Brigham and Women's Hospital, Harvard 
      Medical School, Boston, MA, USA.
AD  - Renal Section, VA Boston Healthcare System, Boston, MA, USA.
FAU - Fagbote, Christopher O
AU  - Fagbote CO
AD  - Department of Pharmacy, VA Boston Healthcare System, Boston, MA, USA.
FAU - Zhuo, Min
AU  - Zhuo M
AD  - Renal Division, Department of Medicine, Beth Israel Deaconess Medical Center, 
      Harvard Medical School, Boston, MA, USA.
FAU - Hawley, Chelsea E
AU  - Hawley CE
AD  - Department of Pharmacy, VA Boston Healthcare System, Boston, MA, USA.
AD  - New England Geriatric Research Education and Clinical Center, VA Boston 
      Healthcare System, Boston, MA, USA.
FAU - Paik, Julie M
AU  - Paik JM
AD  - Renal Division, Department of Medicine, Brigham and Women's Hospital, Harvard 
      Medical School, Boston, MA, USA.
AD  - Renal Section, VA Boston Healthcare System, Boston, MA, USA.
AD  - New England Geriatric Research Education and Clinical Center, VA Boston 
      Healthcare System, Boston, MA, USA.
LA  - eng
GR  - T32 DK007199/DK/NIDDK NIH HHS/United States
PT  - Journal Article
DEP - 20190814
PL  - England
TA  - Clin Kidney J
JT  - Clinical kidney journal
JID - 101579321
PMC - PMC6768299
OTO - NOTNLM
OT  - chronic kidney disease
OT  - deprescribing
OT  - diabetic kidney disease
OT  - polypharmacy
OT  - sodium-glucose cotransporter 2
EDAT- 2019/10/05 06:00
MHDA- 2019/10/05 06:01
PMCR- 2019/08/14
CRDT- 2019/10/05 06:00
PHST- 2019/04/24 00:00 [received]
PHST- 2019/10/05 06:00 [entrez]
PHST- 2019/10/05 06:00 [pubmed]
PHST- 2019/10/05 06:01 [medline]
PHST- 2019/08/14 00:00 [pmc-release]
AID - sfz100 [pii]
AID - 10.1093/ckj/sfz100 [doi]
PST - epublish
SO  - Clin Kidney J. 2019 Aug 14;12(5):620-628. doi: 10.1093/ckj/sfz100. eCollection 
      2019 Oct.