PMID- 32172239
OWN - NLM
STAT- MEDLINE
DCOM- 20210524
LR  - 20210524
IS  - 1421-9670 (Electronic)
IS  - 0250-8095 (Linking)
VI  - 51
IP  - 4
DP  - 2020
TI  - Renal and Cardiovascular Effects of Sodium Glucose Co-Transporter 2 Inhibitors in 
      Patients with Type 2 Diabetes and Chronic Kidney Disease: Perspectives on the 
      Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical 
      Evaluation Trial Results.
PG  - 276-288
LID - 10.1159/000506533 [doi]
AB  - BACKGROUND: Chronic kidney disease (CKD) risk is elevated in patients with type 2 
      diabetes mellitus (T2DM). Disease management in these patients has been generally 
      focused on glycemic control and controlling other renal and cardiac risk factors 
      as, historically, few protective therapies have been available. The Canagliflozin 
      and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation 
      -(CREDENCE) trial of canagliflozin was the first study to demonstrate renal 
      protection with a sodium glucose co-transporter 2 inhibitor in patients with T2DM 
      and CKD, and these results could have important implications for clinical 
      practice. SUMMARY: In CREDENCE, participants with T2DM and estimated glomerular 
      filtration rate 30-<90 mL/min/1.73 m2 and urinary albumin-creatinine ratio 
      >300-5,000 mg/g who were treated with an angiotensin-converting enzyme inhibitor 
      or angiotensin receptor blocker for >/=4 weeks prior to randomization at either the 
      maximum labeled or tolerated dose were randomized to receive either canagliflozin 
      100 mg or placebo. Canagliflozin significantly reduced the risk of the primary 
      composite outcome of doubling of serum creatinine, end-stage kidney disease, or 
      renal or cardiovascular (CV) death compared with placebo (hazard ratio 0.70, 95% 
      CI 0.59-0.82; p = 0.00001). Canagliflozin also reduced the risk of secondary 
      renal and CV outcomes. The safety profile of canagliflozin in CREDENCE was 
      generally similar to previous studies of canagliflozin. No imbalances were 
      observed between canagliflozin and placebo in the risk of amputation or fracture 
      in the CREDENCE population. Key Messages: The positive renal and CV effects of 
      canagliflozin observed in the -CREDENCE trial could have a substantial impact on 
      improving outcomes for patients with T2DM and CKD.
CI  - (c) 2020 S. Karger AG, Basel.
FAU - Weir, Matthew R
AU  - Weir MR
AD  - Division of Nephrology, Department of Medicine, University of Maryland School of 
      Medicine, Baltimore, Maryland, USA, Mweir@som.umaryland.edu.
FAU - McCullough, Peter A
AU  - McCullough PA
AD  - Baylor University Medical Center, Baylor Heart and Vascular Hospital, Baylor 
      Heart and Vascular Institute, Dallas, Texas, USA.
FAU - Buse, John B
AU  - Buse JB
AD  - University of North Carolina School of Medicine, Chapel Hill, North Carolina, 
      USA.
FAU - Anderson, John
AU  - Anderson J
AD  - The Frist Clinic, Nashville, Tennessee, USA.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
DEP - 20200313
PL  - Switzerland
TA  - Am J Nephrol
JT  - American journal of nephrology
JID - 8109361
RN  - 0 (Angiotensin Receptor Antagonists)
RN  - 0 (Angiotensin-Converting Enzyme Inhibitors)
RN  - 0 (Sodium-Glucose Transporter 2 Inhibitors)
RN  - 0SAC974Z85 (Canagliflozin)
RN  - AYI8EX34EU (Creatinine)
SB  - IM
MH  - Angiotensin Receptor Antagonists/administration & dosage
MH  - Angiotensin-Converting Enzyme Inhibitors/administration & dosage
MH  - Canagliflozin/*administration & dosage
MH  - Cardiovascular Diseases/*epidemiology/etiology/physiopathology/prevention & 
      control
MH  - Cardiovascular System/drug effects/physiopathology
MH  - Creatinine/blood
MH  - Diabetes Mellitus, Type 2/complications/*drug therapy
MH  - Disease Progression
MH  - Glomerular Filtration Rate
MH  - Humans
MH  - Kidney/drug effects/physiopathology
MH  - Kidney Failure, Chronic/diagnosis/*epidemiology/physiopathology/prevention & 
      control
MH  - Randomized Controlled Trials as Topic
MH  - Renal Insufficiency, Chronic/complications/*drug therapy/physiopathology
MH  - Sodium-Glucose Transporter 2 Inhibitors/*administration & dosage
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Cardiovascular disease
OT  - Chronic kidney disease
OT  - Randomized trials
OT  - Sodium glucose co-transporter 2 inhibitor
OT  - Type 2 diabetes
EDAT- 2020/03/17 06:00
MHDA- 2021/05/25 06:00
CRDT- 2020/03/16 06:00
PHST- 2019/11/08 00:00 [received]
PHST- 2020/02/17 00:00 [accepted]
PHST- 2020/03/17 06:00 [pubmed]
PHST- 2021/05/25 06:00 [medline]
PHST- 2020/03/16 06:00 [entrez]
AID - 000506533 [pii]
AID - 10.1159/000506533 [doi]
PST - ppublish
SO  - Am J Nephrol. 2020;51(4):276-288. doi: 10.1159/000506533. Epub 2020 Mar 13.