Role and mechanisms of SGLT-2 inhibitors in the treatment of diabetic kidney disease

Frontiers in Immunology

Immunology

Zhi-Cheng Dai¹  Jin-Xia Chen¹  Cui-Wei Yao¹  Ji-Xin Tang¹  Rong Zou¹  Xuan-Bing Liang¹ 

[1] Guangdong Provincial Key Laboratory of Autophagy and Major Chronic Non-communicable Diseases, Key Laboratory of Prevention and Management of Chronic Kidney Diseases of Zhanjiang City, Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China;

关键词: SGLT-2 inhibitor;    diabetic kidney disease;    renal protection mechanism;    efficacy;    safety;   

DOI  :  10.3389/fimmu.2023.1213473

 received in 2023-04-28, accepted in 2023-09-06,  发布年份 2023

来源: Frontiers

【 摘 要 】

Diabetic kidney disease (DKD) is a chronic inflammatory condition that affects approximately 20-40% of individuals with diabetes. Sodium-glucose co-transporter 2 (SGLT-2) inhibitors, emerging as novel hypoglycemic agents, have demonstrated significant cardiorenal protective effects in patients with DKD. Initially, it was believed that the efficacy of SGLT-2 inhibitors declined as the estimated glomerular filtration rate (eGFR) decreased, which led to their preferential use in DKD patients at G1-G3 stages. However, recent findings from the DAPA-CKD and EMPA-KIDNEY studies have revealed equally beneficial cardiorenal effects of SGLT-2 inhibitors in individuals at stage G4 DKD, although the underlying mechanism behind this phenomenon remains unclear. In this comprehensive analysis, we provide a systematic review of the mechanisms and functioning of SGLT-2 inhibitors, potential renal protection mechanisms, and the therapeutic efficacy and safety of SGLT-2 inhibitors in kidney diseases, with a particular focus on stage G4 DKD. Gaining a deeper understanding of the renal protective effect of SGLT-2 inhibitors and their underlying mechanisms is highly significance for the successful utilization of these inhibitors in the treatment of diverse kidney disorders.

【 授权许可】

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Copyright © 2023 Dai, Chen, Zou, Liang, Tang and Yao