TY - JOUR
T1 - Renal protection
T2 - a leading mechanism for cardiovascular benefit in patients treated with SGLT2 inhibitors
AU - Margonato, Davide
AU - Galati, Giuseppe
AU - Mazzetti, Simone
AU - Cannistraci, Rosa
AU - Perseghin, Gianluca
AU - Margonato, Alberto
AU - Mortara, Andrea
PY - 2020
Y1 - 2020
N2 - Initially developed as glucose-lowering drugs, sodium-glucose co-transporter type 2 inhibitors (SGLT2i) have demonstrated to be effective agents for the risk reduction of cardiovascular (CV) events in patients with type 2 diabetes mellitus (T2DM). Subsequently, data has emerged showing a significant CV benefit in patients treated with SGLT2i regardless of diabetes status. Renal protection has been initially evaluated in CV randomized trials only as secondary endpoints; nonetheless, the positive results gained have rapidly led to the evaluation of nephroprotection as primary outcome in the CREDENCE trial. Different renal and vascular mechanisms can account for the CV and renal benefits enlightened in recent literature. As clinical guidelines rapidly evolve and the role of SGLT2i appears to become pivotal for CV, T2DM, and kidney disease management, in this review, we analyze the renal effects of SGLT2, the benefits derived from its inhibition, and how this may result in the multiple CV and renal benefits evidenced in recent clinical trials.
AB - Initially developed as glucose-lowering drugs, sodium-glucose co-transporter type 2 inhibitors (SGLT2i) have demonstrated to be effective agents for the risk reduction of cardiovascular (CV) events in patients with type 2 diabetes mellitus (T2DM). Subsequently, data has emerged showing a significant CV benefit in patients treated with SGLT2i regardless of diabetes status. Renal protection has been initially evaluated in CV randomized trials only as secondary endpoints; nonetheless, the positive results gained have rapidly led to the evaluation of nephroprotection as primary outcome in the CREDENCE trial. Different renal and vascular mechanisms can account for the CV and renal benefits enlightened in recent literature. As clinical guidelines rapidly evolve and the role of SGLT2i appears to become pivotal for CV, T2DM, and kidney disease management, in this review, we analyze the renal effects of SGLT2, the benefits derived from its inhibition, and how this may result in the multiple CV and renal benefits evidenced in recent clinical trials.
KW - Cardiovascular outcomes
KW - Chronic kidney disease
KW - Heart failure
KW - Renal protection
KW - SGLT2 inhibitors
KW - Type 2 diabetes mellitus
UR - http://www.scopus.com/inward/record.url?scp=85090430260&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85090430260&partnerID=8YFLogxK
U2 - 10.1007/s10741-020-10024-2
DO - 10.1007/s10741-020-10024-2
M3 - Review article
AN - SCOPUS:85090430260
JO - Heart Failure Reviews
JF - Heart Failure Reviews
SN - 1382-4147
ER -