efficacy and safety of dapagliflozin in patients with ckd: Real world experience in 93 italian renal clinics DOI Creative Commons
Roberto Minutolo, Silvio Borrelli,

A Ambrosini

et al.

Clinical Kidney Journal, Journal Year: 2024, Volume and Issue: 18(1)

Published: Dec. 3, 2024

Sodium-glucose co-transporter-2 inhibitors (SGLT2i) are recommended for reducing the renal and cardiovascular risk in patients with chronic kidney disease (CKD) based on positive results reported by clinical trials. However, real-world data efficacy safety of these drugs CKD population followed nephrology setting lacking. We report effects dapagliflozin using collected during a learning program which 105 nephrologists added (10 mg/day) to consecutive referred their clinics. Efficacy endpoints were albuminuria change determinants an decline ≥30%. Adverse events also collected. A total 1724 (age 67.4 ± 13.2 years, 72.8% males, diabetes 59.9%, eGFR 43.5 17.4 ml/min/1.73 m2, severe 70.1%) received 4 1 months. Dapagliflozin significantly reduced body weight (-1.3 kg), (-0.27 ml/min/month), blood pressure (-3.6/-1.7 mmHg). Albuminuria declined 25.1% (95%CI 23.0-27.2) from 500 mg/day [IQR 225-1425] 320 100-900]. reduction was ≥30% 48.3% patients, 0-29% 37.6% while it increased 14.1% patients. At logistic regression analysis, older age, female sex, use mineralocorticoid receptor antagonist, higher eGFR, all significant predictors 46 side leading drug discontinuation 36 (2%), acute injury urinary tract infection being most frequent adverse events. provide evidence anti-proteinuric short-term presence good profile nephrology.

Language: Английский

Early Identification and Management of Chronic Kidney Disease: A Narrative Review of the Crucial Role of Primary Care Practitioners DOI Creative Commons
Pamela Kushner, Kamlesh Khunti,

Ana Cebrián

et al.

Advances in Therapy, Journal Year: 2024, Volume and Issue: 41(10), P. 3757 - 3770

Published: Aug. 20, 2024

Early-stage (stage 1–3) chronic kidney disease (CKD) has an asymptomatic presentation such that most people with CKD are unaware of their status and remain undiagnosed. is associated multiple long-term conditions (MLTC), or multimorbidity, the common these being cardiovascular disease, hypertension, type 2 diabetes. Primary care practitioners (PCPs) crucial in early identification management patients CKD. For individuals at high risk CKD, measurements estimated glomerular filtration rate, urine albumin–creatinine ratio, blood pressure should be obtained regularly recorded a timely manner. The importance lifestyle changes prevention also highlighted. A recent addition to treatment without diabetes been recommendation by clinical practice guidelines sodium–glucose co-transporter (SGLT2) inhibitor alongside renin–angiotensin–aldosterone system as foundational therapy. SGLT2 inhibitors prevent progression reduce fatal non-fatal events, hospitalization for heart failure, all-cause mortality, they have favorable safety tolerability profile. However, uptake slow, particularly multifaceted approach required ensure receive optimal protection. Measures raise awareness intervention include local/national campaigns via social media practice-based education; education programs; integration decision support tools into electronic health records; detection programs built around good interdisciplinary communication. PCPs forefront multidisciplinary best placed implement evidence-based modification guideline-directed medical Chronic affects about one ten adults worldwide. Results from many real-world studies show getting worse. because can no symptoms its stages, it often not diagnosed. Many therefore it. People likely other issues well, including hypertension offer holistic, patient-centered those frontline identifying managing factors disease. may advise on changes, diet exercise, well helping them understand what treatments available. Sodium–glucose shown strong kidney-protective effects trials, recently updated recommend use therapy more established These prescribed whether not. primary obtain record function pressure. Public practitioner education, tools, communication between healthcare professionals all important drive change improve

Language: Английский

Citations

6
Letter: Cardiovascular Events in Chronic Kidney Diseases: Related Factors Besides Naples Prognostic Score DOI Creative Commons
Yusuf Ziya Şener,

Arzu Yazar

Angiology, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 16, 2025

Language: Английский

Citations

0
Challenges, current innovations, and opportunities for managing type 2 diabetes in frail older adults: a position paper of the European Geriatric Medicine Society (EuGMS)—Special Interest Group in Diabetes DOI Creative Commons
Virginia Boccardi,

Gülistan Bahat,

Cafer Balcı

et al.

European Geriatric Medicine, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 27, 2025

This position paper aims to address the challenges of managing type 2 diabetes mellitus (T2DM) in frail older adults, a diverse and growing demographic with significant variability health status. The primary research questions are: How can frailty assessment be effectively integrated into care? What strategies optimize glycaemic control outcomes for adults? innovative tools technologies, including artificial intelligence (AI), improve management this population? uses 5 I's framework (Identification, Innovation, Individualization, Integration, Intelligence) integrate care, proposing such as tools, novel therapies, digital AI systems. It also examines metabolic heterogeneity, highlighting anorexic-malnourished sarcopenic-obese phenotypes. proposed highlights importance tailoring targets levels, prioritizing quality life, minimizing treatment burden. Strategies leveraging are emphasized their potential enhance personalized care. distinct needs two phenotypes outlined, specific recommendations each group. calls holistic, patient-centered approach care ensuring equity access innovations life. need fill evidence gaps, refine healthcare integration better vulnerable

Language: Английский

Citations

0
SGLT-2i—A Useful Tool for Real-Life Metabolic and Body Weight Control in Type 2 Diabetes Mellitus Patients DOI Creative Commons

Mihaela-Simona Popoviciu,

Teodor Salmen, Delia Reurean‐Pintilei

et al.

Medicina, Journal Year: 2025, Volume and Issue: 61(3), P. 548 - 548

Published: March 20, 2025

Background and Objectives: Elevated blood sugar poses an increasingly significant challenge to healthcare systems worldwide. We aimed assess the efficacy of SGLT-2i class in achieving metabolic control patients with T2DM within a real-world standard-of-care regimen. Material Methods: A prospective analysis was conducted over 6 months including individuals receiving care outpatient department, baseline assessments follow-ups at 3 months. Results: total 280 were assessed, mean age 63.69 ± 9.16, 53.9% which males, DM duration 9.06 5.64 years, varying from 24 years. Discussion: Real-world evidence bridges gap between guidelines practice. It emphasizes need overcome clinical inertia order optimize patient outcomes contributes body supporting fixed-dose combinations managing associated comorbidities. Conclusions: demonstrate therapeutic impact setting. This medication not only positively influences glycemic weight but also reduces CV risk factors visceral adiposity.

Language: Английский

Citations

0
Updates in chronic kidney disease management: A systematic review DOI Open Access
Amina Ammar, Stephanie B. Edwin, Rachel Whitney

et al.

Pharmacotherapy The Journal of Human Pharmacology and Drug Therapy, Journal Year: 2025, Volume and Issue: unknown

Published: March 28, 2025

Abstract Chronic kidney disease (CKD) is a significant global health challenge that impacts both patients and the care system. This systematic review aims to evaluate efficacy safety of emerging therapeutic strategies for CKD management, including sodium‐glucose cotransporter 2 inhibitors (SGLT2i), glucagon‐like peptide‐1 receptor agonists (GLP‐1RA), finerenone, sacubitril/valsartan, potassium binders. We conducted searches in databases PubMed, Scopus, CINAHL Complete, Web Science Core Collection identify experimental observational studies pertaining each these agents. Included were those enrolled adult with who evaluated SGLT2i, GLP‐1RA, binders compared other medications or placebo renal‐related outcomes as primary secondary outcome. Methodological quality risk bias assessed using Cochrane Risk Bias (version 2) tool ROBINS‐I studies. After screening 2135 unique studies, 138 eligible this review. These describe substantial growing body evidence focused on improving management beyond renin‐angiotensin system (RASi), such angiotensin‐converting enzyme (ACEi) angiotensin blockers (ARBs). Currently, SGLT2i have demonstrated consistent benefits large effect sizes preventing progression CKD, solidifying class first‐line treatment along RASi. Subsequent consideration sacubitril/valsartan should be dependent patient‐specific comorbidities, while may allow longer use

Language: Английский

Citations

0
Cardiovascular therapeutic targets of sodium-glucose co-transporter 2 (SGLT2) inhibitors beyond heart failure DOI Creative Commons
Matteo Armillotta,

Francesco Angeli,

Pasquale Paolisso

et al.

Pharmacology & Therapeutics, Journal Year: 2025, Volume and Issue: 270, P. 108861 - 108861

Published: April 15, 2025

Sodium-glucose co-transporter 2 (SGLT2) inhibitors are oral antidiabetic agents that have shown significant improvements in cardiovascular and renal outcomes among patients with heart failure (HF), regardless of diabetic status, establishing them as a cornerstone therapy. In addition to glycemic control the osmotic diuretic effect, inhibition SGLT2 improves endothelial function vasodilation, optimizing myocardial energy metabolism preserving cardiac contractility. Moreover, may exhibit anti-inflammatory properties attenuate acute ischemia/reperfusion injury, thereby reducing infarct size, enhancing left ventricular function, mitigating arrhythmias. These pleiotropic effects demonstrated efficacy across various conditions, ranging from chronic coronary syndromes extending arrhythmias, valvular disease, cardiomyopathies, cardio-oncology, cerebrovascular disease. This review provides an overview current literature on potential mechanisms underlying effectiveness wide range diseases beyond HF.

Language: Английский

Citations

0
Dapagliflozin ameliorates intestinal stem cell aging by regulating the MAPK signaling pathway in Drosophila DOI Creative Commons
Jinhua Yan,

Chenxi Feng,

H Zhang

et al.

Frontiers in Cell and Developmental Biology, Journal Year: 2025, Volume and Issue: 13

Published: April 23, 2025

Introduction Intestinal stem cells (ISCs) possess the ability to self-renew and differentiate, which is essential for maintaining intestinal tissue homeostasis. However, their functionality significantly declines with age, leading diminished regeneration an increased risk of age-associated diseases. Methods This study investigates effects Dapagliflozin (DAPA), a novel insulin sensitizer SGLT2 inhibitor, on aging ISCs using Drosophila melanogaster model. Our findings demonstrate that DAPA can inhibit MAPK signaling pathway, as confirmed by network pharmacology analysis molecular docking experiments. Results ameliorates ISC aging, improves function (including enhanced fecal excretion, restored barrier integrity acid-base balance), enhances healthspan. These results highlight potential anti-aging therapeutic agent. Discussion provides new evidence application treatment.

Language: Английский

Citations

0
Semaglutide for Chronic Kidney Disease in Type 2 Diabetes DOI
Vlado Perkovic, Katherine R. Tuttle, Richard E. Pratley

et al.

New England Journal of Medicine, Journal Year: 2024, Volume and Issue: 391(18), P. 1757 - 1757

Published: Nov. 6, 2024

Language: Английский

Citations

2
Empagliflozin attenuates hypoxia-induced heart failure of zebrafish embryos via influencing MMP13 expression DOI Open Access

R Huttunen,

A-M Haapanen-Saaristo,

Anja Hjelt

et al.

Biomedicine & Pharmacotherapy, Journal Year: 2024, Volume and Issue: 180, P. 117453 - 117453

Published: Sept. 26, 2024

Language: Английский

Citations

1
efficacy and safety of dapagliflozin in patients with ckd: Real world experience in 93 italian renal clinics DOI Creative Commons
Roberto Minutolo, Silvio Borrelli,

A Ambrosini

et al.

Clinical Kidney Journal, Journal Year: 2024, Volume and Issue: 18(1)

Published: Dec. 3, 2024

Sodium-glucose co-transporter-2 inhibitors (SGLT2i) are recommended for reducing the renal and cardiovascular risk in patients with chronic kidney disease (CKD) based on positive results reported by clinical trials. However, real-world data efficacy safety of these drugs CKD population followed nephrology setting lacking. We report effects dapagliflozin using collected during a learning program which 105 nephrologists added (10 mg/day) to consecutive referred their clinics. Efficacy endpoints were albuminuria change determinants an decline ≥30%. Adverse events also collected. A total 1724 (age 67.4 ± 13.2 years, 72.8% males, diabetes 59.9%, eGFR 43.5 17.4 ml/min/1.73 m2, severe 70.1%) received 4 1 months. Dapagliflozin significantly reduced body weight (-1.3 kg), (-0.27 ml/min/month), blood pressure (-3.6/-1.7 mmHg). Albuminuria declined 25.1% (95%CI 23.0-27.2) from 500 mg/day [IQR 225-1425] 320 100-900]. reduction was ≥30% 48.3% patients, 0-29% 37.6% while it increased 14.1% patients. At logistic regression analysis, older age, female sex, use mineralocorticoid receptor antagonist, higher eGFR, all significant predictors 46 side leading drug discontinuation 36 (2%), acute injury urinary tract infection being most frequent adverse events. provide evidence anti-proteinuric short-term presence good profile nephrology.

Language: Английский

Citations

0