PMID- 32996085
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210110
IS  - 1869-6953 (Print)
IS  - 1869-6961 (Electronic)
IS  - 1869-6961 (Linking)
VI  - 11
IP  - 12
DP  - 2020 Dec
TI  - SGLT2 Inhibitors: Slowing of Chronic Kidney Disease Progression in Type 2 
      Diabetes.
PG  - 2757-2774
LID - 10.1007/s13300-020-00930-x [doi]
AB  - Diabetic kidney disease (DKD) is a topic of increasing concern among clinicians 
      involved in the management of type 2 diabetes mellitus (T2DM). It is a 
      progressive and costly complication associated with increased risk of adverse 
      cardiovascular (CV) and renal outcomes and mortality. Ongoing monitoring of the 
      estimated glomerular filtration (eGFR) rate alongside the urine 
      albumin:creatinine ratio (ACR) is recommended during regular T2DM reviews to 
      enable a prompt DKD diagnosis or to assess disease progression, providing an 
      understanding of adverse risk for each individual. Many people with DKD will 
      progress to end-stage kidney disease (ESKD), requiring renal replacement therapy 
      (RRT), typically haemodialysis or kidney transplantation. A range of lifestyle 
      and pharmacological interventions is recommended to help lower CV risk, slow the 
      advancement of DKD and prevent or delay the need for RRT. Emerging evidence 
      concerning sodium-glucose co-transporter-2 inhibitor (SGLT2i) agents suggests a 
      role for these medicines in slowing eGFR decline, enabling regression of 
      albuminuria and reducing progression to ESKD. Improvements in renal end points 
      observed in SGLT2i CV outcome trials (CVOTs) highlighted the possible impact of 
      these agents in the management of DKD. Data from the canagliflozin CREDENCE trial 
      (Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical 
      Evaluation) have since demonstrated the effectiveness of this medicine in 
      reducing the risk of kidney failure and CV events in a population comprising 
      individuals with T2DM and renal disease. CREDENCE was the first SGLT2i study to 
      examine renal outcomes as the primary end point. Real-world studies have 
      reaffirmed these outcomes in routine clinical practice. This article summarises 
      the evidence regarding the use of SGLT2i medicines in slowing the progression of 
      DKD and examines the possible mechanisms underpinning the renoprotective effects 
      of these agents. The relevant national and international guidance for monitoring 
      and treatment of DKD is also highlighted to help clinicians working to support 
      this vulnerable group.
FAU - Wheeler, David C
AU  - Wheeler DC
AD  - University College London, London, UK.
FAU - James, June
AU  - James J
AD  - University Hospitals of Leicester NHS Trust, University of Leicester, Leicester, 
      UK.
FAU - Patel, Dipesh
AU  - Patel D
AD  - University College London, London, UK.
FAU - Viljoen, Adie
AU  - Viljoen A
AD  - Lister Hospital, Stevenage, UK.
FAU - Ali, Amar
AU  - Ali A
AD  - Oakenhurst Medical Practice, Blackburn, UK.
FAU - Evans, Marc
AU  - Evans M
AD  - University Hospital Llandough, Penarth, UK.
FAU - Fernando, Kevin
AU  - Fernando K
AD  - North Berwick Health Centre, North Berwick, UK.
FAU - Hicks, Debbie
AU  - Hicks D
AD  - Medicus Health Partners, Enfield, UK.
FAU - Milne, Nicola
AU  - Milne N
AD  - Manchester University NHS Foundation Trust, Manchester, UK.
FAU - Newland-Jones, Philip
AU  - Newland-Jones P
AD  - University Hospitals Southampton NHS Foundation Trust, Southampton, UK.
FAU - Wilding, John
AU  - Wilding J
AD  - University of Liverpool, Liverpool, UK. J.P.H.Wilding@liverpool.ac.uk.
CN  - as part of the Improving Diabetes Steering Committee
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20200929
PL  - United States
TA  - Diabetes Ther
JT  - Diabetes therapy : research, treatment and education of diabetes and related 
      disorders
JID - 101539025
PMC - PMC7524028
OTO - NOTNLM
OT  - Chronic kidney disease
OT  - Diabetic kidney disease
OT  - End-stage kidney disease
OT  - Kidney failure
OT  - Oral glucose-lowering medicines
OT  - SGLT2 inhibitors
OT  - Type 2 diabetes
EDAT- 2020/10/01 06:00
MHDA- 2020/10/01 06:01
PMCR- 2020/09/29
CRDT- 2020/09/30 06:19
PHST- 2020/08/03 00:00 [received]
PHST- 2020/09/11 00:00 [accepted]
PHST- 2020/10/01 06:00 [pubmed]
PHST- 2020/10/01 06:01 [medline]
PHST- 2020/09/30 06:19 [entrez]
PHST- 2020/09/29 00:00 [pmc-release]
AID - 10.1007/s13300-020-00930-x [pii]
AID - 930 [pii]
AID - 10.1007/s13300-020-00930-x [doi]
PST - ppublish
SO  - Diabetes Ther. 2020 Dec;11(12):2757-2774. doi: 10.1007/s13300-020-00930-x. Epub 
      2020 Sep 29.