• Chronic kidney diseases frequently occur as a complication in patients with type 2 diabetes mellitus.
• It is associated with poor clinical outcomes, including an increased risk of all-cause and cardiovascular mortality, as well as adverse economic and social effects.
• Controlling the progression and development of CKD continues to be an unmet need for clinical management of patients with type 2 diabetes.
• Sodium glucose co-transporter 2 (SGLT2) inhibitors are generally used in the management of type 2 diabetes mellitus.
• It exhibits clinical effects of cardiovascular benefits and potential renoprotective effects in addition to the glucose lowering effects.
• Research has shown that these agents can lower the risk of development or worsening of albuminuria, which is a marker of renal damage via several mechanisms. These include blood pressure-reducing, reduction of intraglomerular pressure and hyperfiltration, modification of inflammatory processes, reduction of ischemia-related injury, and increases in glucagon levels.
• The use of SGLT2 inhibitors is associated with blood pressure reduction and it is also maintained in people with CKD and could further contribute to reduce renal burden, as well as potentially offering synergistic effects with antihypertensive therapies in these patients.
• In patients with type 2 diabetes mellitus and CKD, SGLT2 inhibitors have a reduced glucose-lowering effect compared to patients without CKD.
• The use of SGLT2 inhibitors have similar renal benefits in patients with and without CKD and include a significant reduction in albuminuria and reduced incidence of worsening albuminuria.
• These agents are preferred add-on agents in most patients with uncontrolled type 2 diabetes mellitus and eGFR?30 ml/min/1.73 m2.

Resource

1. Davidson JA. SGLT2 inhibitors in patients with type 2 diabetes and renal disease: Overview of current evidence. Postgrad Med. 2019; 131: 251-260.
2. Kelly MS, Lewis J, Huntsberry AM, Dea L, Portillo I. Efficacy and renal outcomes of SGLT2 inhibitors in patients with type 2 diabetes and chronic kidney disease. Postgrad Med. 2019; 131:31-42.