BMC Nephrology, Journal Year: 2024, Volume and Issue: 25(1)
Published: Nov. 1, 2024
This meta-analysis was designed to investigate cardio-renal outcomes and safety of sodium-glucose cotransporter-2 inhibitors (SGLT2i) as a therapeutic option among chronic kidney disease(CKD) patients with GFR < 60 mL/min/1.73 m2, regardless their diabetic status.
Language: Английский
Diabetology & Metabolic Syndrome, Journal Year: 2025, Volume and Issue: 17(1)
Published: Jan. 6, 2025
Our meta-analysis fills gaps by assessing sodium-glucose cotransporter-2 (SGLT2) inhibitors' renal outcomes in chronic kidney disease (CKD) patients including long-term effects and the subgroup analyses of estimated glomerular filtration rate (eGFR) values follow-up times. The literature search relevant randomized controlled trials (RCTs) was conducted Medline, Embase, Cochrane Central from inception to 8 June 2023 on with CKD treated SGLT2 inhibitors. We selected medical subject heading (MeSH) terms free text associated gliflozin RCT. calculated odds ratio (OR) or harzard 95% confidence intervals (CIs) for composite dichotomous data, weighted mean differences (WMD) changes eGFR. 16 RCTs enrolling 52,306 were final population, 26,910 being inhibitors 25,396 serving as controls identified. found that there no decline change eGFR after 13 weeks treatment significantly improved 64 (64–104 weeks: WMD, 1.024 mL/min/1.73m2/per year, CI 0.643–1.406; 104 0.978, 0.163–1.794).SGLT2 reduced risk acute injury (AKI) (OR 0.836; 0.747–0.936; I2 = 0%), mainly derived empagliflozin (P 0.001) increased incidence volume-related adverse events (AEs) 23%.However, statically observed death due 0.182) < 15 mL/min/1.73 m2 0.202). results our showed treatment, a significant benefit further improvement slighter lower values. Additionally, reduce AKI when using empagliflozin, while is an AEs exclusively stage 2 CKD. Trial registration CRD42023437061. latest guidelines endocrinology advocated use potential beneficial kidney. However, initial decline(dip) little data evaluating disparate stages serve deterring factors clinicians Different other meta-analyses, we follow up duration more than Further, progression outcomes, but statistically sustained eGFR<15 m2. Moreover, safety indicate
Language: Английский
Citations
1
Kidney and Dialysis, Journal Year: 2024, Volume and Issue: 4(4), P. 184 - 202
Published: Oct. 24, 2024
The history of sodium-glucose cotransporter 2 inhibitors (SGLT2i) is so long and started in 1835 when Petersen extracted a compound called phlorizin from apple tree bark. About fifty years later, von Mering discovered its glucosuric properties. In the 1980s, it was that glucosuria resulted inhibition by glucose reabsorption renal tubules, which lowered blood levels diabetic rats. Nowadays, beyond their glucose-lowering effects, growing evidence suggests significant cardiorenal benefits associated with SGLT2i therapy. Indeed, several clinical trials, including landmark studies such as EMPA-REG OUTCOME, CANVAS Program, DECLARE-TIMI 58, have demonstrated robust reductions cardiovascular events, particularly heart failure hospitalizations mortality, among patients treated SGLT2i. However, subsequent trials showed extend population, encompassing individuals without diabetes. Additionally, exhibit nephroprotective manifesting slowing progression chronic kidney disease reduction risk end-stage disease. mechanisms underlying are multifactorial include improvements glycemic control, arterial stiffness, modulation inflammation oxidative stress, intraglomerular pression promotion natriuresis diuresis through SGLT2 luminal brush border first segments proximal tubule. This narrative review aims to explore outcomes SGLT2i, action, evidence, safety profile, implications for practice.
Language: Английский
Citations
2
International Journal of Molecular Sciences, Journal Year: 2023, Volume and Issue: 24(24), P. 17380 - 17380
Published: Dec. 12, 2023
Herein, we measured the antidiabetic and nephroprotective effects of sodium-glucose cotransporter-2 inhibitor (empagliflozin; SGLT2i) synthetic active vitamin D (paricalcitol; Pcal) mono- co-therapy against diabetic nephropathy (DN). Fifty mice were assigned into negative (NC) positive (PC) control, SGLT2i, Pcal, SGLT2i+Pcal groups. Following establishment DN, SGLT2i (5.1 mg/kg/day) and/or Pcal (0.5 µg/kg/day) used in designated groups (5 times/week/day). DN was affirmed PC group by hyperglycaemia, dyslipidaemia, polyuria, proteinuria, elevated urine protein/creatinine ratio, abnormal renal biochemical parameters. Renal SREBP-1 lipogenic molecule, adipokines (leptin/resistin), pro-oxidant (MDA/H2O2), pro-inflammatory (IL1β/IL6/TNF-α), tissue damage (iNOS/TGF-β1/NGAL/KIM-1), apoptosis (TUNEL/Caspase-3) markers also increased group. In contrast, lipolytic (PPARα/PPARγ), adiponectin, antioxidant (GSH/GPx1/SOD1/CAT), anti-inflammatory (IL10) molecules decreased Both monotherapies insulin levels mitigated profiles alongside lipid regulatory molecules, inflammation, oxidative stress. While monotherapy showed superior to their combination demonstrated enhanced remedial actions related metabolic control stress, apoptosis. conclusion, better than revealed nephroprotection, plausibly glycaemic with boosted antioxidative mechanisms.
Language: Английский
Citations
2
Medicina, Journal Year: 2024, Volume and Issue: 60(8), P. 1198 - 1198
Published: July 24, 2024
: Peritoneal dialysis (PD) is a renal replacement therapy modality in which the dose can be individually adapted according to patients' residual kidney function (RKF). RKF crucial factor for technique and patient survival. Pharmacological strategies aimed at slowing loss of patients on PD are limited. Therefore, we assess potential effects safety sodium-glucose cotransporter 2 (SGLT-2) inhibitors preservation with without type diabetes mellitus (T2DM) during an average follow-up 6 months.
Language: Английский
Citations
0
Brazilian Journal of Health Review, Journal Year: 2024, Volume and Issue: 7(4), P. e72295 - e72295
Published: Aug. 28, 2024
A doença renal crônica (DRC) é uma condição progressiva que pode levar à falência e aumento da mortalidade, sendo agravada pela presença de diabetes mellitus (DM). Os inibidores do cotransportador sódio-glicose 2 (SGLT2) emergiram como opção terapêutica promissora tanto para pacientes com DRC DM quanto aqueles sem DM. objetivos dos estudos recentes incluem avaliar a eficácia SGLT2 na redução progressão DRC, diminuição eventos cardiovasculares melhoria qualidade vida pacientes. Esses visam entender se os benefícios observados em também aplicam aos explorar mecanismos subjacentes contribuem esses efeitos benéficos. resultados mais indicam SGLT2, empagliflozina dapagliflozina, são eficazes retardar reduzir riscos cardiovasculares, independentemente Em conclusão, representam inovação no manejo oferecendo substanciais Essas descobertas ampliam as opções terapêuticas disponíveis destacam necessidade abordagem integrada tratamento focando não apenas controle glicêmico, mas proteção cardiovascular.
Citations
0
BMC Nephrology, Journal Year: 2024, Volume and Issue: 25(1)
Published: Nov. 1, 2024
This meta-analysis was designed to investigate cardio-renal outcomes and safety of sodium-glucose cotransporter-2 inhibitors (SGLT2i) as a therapeutic option among chronic kidney disease(CKD) patients with GFR < 60 mL/min/1.73 m2, regardless their diabetic status.
Language: Английский
Citations
0