A new era of diabetic kidney disease treatment with sodium–glucose cotransporter‐2 inhibitors

Kume, Shinji; Maegawa, Hiroshi

doi:10.1111/jdi.13747

Cited by 5 publications

(4 citation statements)

References 19 publications

(25 reference statements)

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“…Future studies should explore change of albuminuria under fasting interventions in larger study cohort and should also investigate whether the classical albuminuric DKD and the new-emerging nonalbuminuric DKD are driven from distinct pathophysiological mechanisms. There is growing epidemiological evidence on the heterogeneity in the clinical presentation and course of DKD with divergence between albuminuria and GFR decline ( 52 , 53 ), challenging, on one hand, the albuminuria-centric model of the natural course of DKD and, on the other hand, suggesting that albuminuria is a dynamic process ( 42 , 54 ).…”

Section: Discussionmentioning

confidence: 99%

Six-Month Periodic Fasting in Patients With Type 2 Diabetes and Diabetic Nephropathy: A Proof-of-Concept Study

Sulaj

Kopf

Rauchhaupt

et al. 2022

The Journal of Clinical Endocrinology &Amp; Metabolism

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Context Novel fasting interventions have gained scientific and public attention. Periodic fasting has emerged as a dietary modification promoting beneficial effects on metabolic syndrome. Objective Assess whether periodic fasting reduces albuminuria and activates nephropathy-driven pathways. Design/Participants Proof-of-concept study where individuals with type 2 diabetes (n = 40) and increased albumin-to-creatinine ratio (ACR) were randomly assigned to receive a monthly fasting-mimicking diet (FMD) or a Mediterranean diet for 6 months with 3-month follow-up. Main Outcomes Measures Change in ACR was assessed by analysis of covariance adjusted for age, sex, weight loss, and baseline value. Prespecified subgroup analysis for patients with micro- vs macroalbuminuria at baseline was performed. Change in homeostatic model assessment for insulin resistance (HOMA-IR), circulating markers of dicarbonyl detoxification (methylglyoxal-derived hydroimidazolone 1, glyoxalase-1, and hydroxyacetone), DNA-damage/repair (phosphorylated histone H2AX), lipid oxidation (acylcarnitines), and senescence (soluble urokinase plasminogen activator receptor) were assessed as exploratory endpoints. Results FMD was well tolerated with 71% to 95% of the participants reporting no adverse effects. After 6 months, change in ACR was comparable between study groups [110.3 (99.2, 121.5) mg/g; P = 0.45]. FMD led to a reduction of ACR in patients with microalbuminuria levels at baseline [−30.3 (−35.7, −24.9) mg/g; P ≤ 0.05] but not in those with macroalbuminuria [434.0 (404.7, 463.4) mg/g; P = 0.23]. FMD reduced HOMA-IR [−3.8 (−5.6, −2.0); P ≤ 0.05] and soluble urokinase plasminogen activator receptor [−156.6 (−172.9, −140.4) pg/mL; P ≤ 0.05], while no change was observed in markers of dicarbonyl detoxification or DNA-damage/repair. Change in acylcarnitines was related to patient responsiveness to ACR improvement. At follow-up only HOMA-IR reduction [−1.9 (−3.7, −0.1), P ≤ 0.05]) was sustained. Conclusions Improvement of microalbuminuria and of markers of insulin resistance, lipid oxidation, and senescence suggest the potential beneficial effects of periodic fasting in type 2 diabetes.

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Section: Discussionmentioning

confidence: 99%

Six-Month Periodic Fasting in Patients With Type 2 Diabetes and Diabetic Nephropathy: A Proof-of-Concept Study

Sulaj

Kopf

Rauchhaupt

et al. 2022

The Journal of Clinical Endocrinology &Amp; Metabolism

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“…In terms of the effectiveness of renal outcomes, SGLT2is are known to delay the decline in renal function in diabetic kidney disease in both SGLT2i outcome trials and in large real‐world clinical practice settings 10 . These renoprotective effects in diabetic kidney disease have also been observed in Asian paople 10 . In recent SGLT2i trials, a reduction in the risk of composite outcome, including a decline in estimated glomerular filtration rate (eGFR), end‐stage kidney disease or death from renal causes, was also shown among Asian people 11,12 .…”

Section: Outcomes Study Findingsmentioning

confidence: 99%

mentioning

confidence: 99%

Effectiveness and safety of sodium–glucose cotransporter 2 inhibitors in Asian populations

Ha,

Kim

2023

J of Diabetes Invest

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“…Por consiguiente, los inhibidores han comenzado a mostrar beneficios adicionales sobre el pronóstico renal en pacientes con nefropatía diabética. Con el uso adecuado, se espera que el pronóstico de nefropatía diabética mejore aún más en los próximos 20 años (9). Esta revisión analizará los efectos de nefroproctección del empleo en inhibidores del cotransportador de sodio-glucosa 2 en la nefropatía diabética, considerando las estrategias terapéuticas basadas en la farmacocinética y farmacodinamia.…”

Section: Introductionunclassified

Efectividad del uso de inhibidores del cotransportador de sodio-glucosa 2 en la nefropatía diabética

Porras-Reyes,

Novillo-Cevallos

2023

MQRInvestigar

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Introducción: La nefropatía diabética se considera una complicación microvascular con un riesgo 25 veces mayor para producir insuficiencia renal crónica. Dentro de las alternativas de tratamiento, los inhibidores del cotransportador de sodio-glucosa 2 ha demostrado decrecimiento en hemoglobina glicosilada (HbA1c) y efectos favorables sobre el riñón. Por consiguiente, los inhibidores han comenzado a mostrar beneficios adicionales sobre el pronóstico renal en pacientes con nefropatía diabética. Con el uso adecuado, se espera que el pronóstico de nefropatía diabética mejore en los próximos 20 años. Objetivo General: Describir la eficacia del uso de inhibidores del cotransportador de sodio-glucosa 2 en pacientes con nefropatía diabética. Metologìa: se llevó a cabo una revisión bibliográfica tipo narrativa utilizando buscadores tales como Pubmed, Scopus, Scielo, Science Direct, Uptodate, efectuando estudios publicados 2018 al 2022. Se aplicó el diagrama PRISMA con una muestra inicial de 50 artículos considerando 31 los cuales fueron utilizados en el presente trabajo. Resultados se eligió 10 artículos. Los resultados obtenidos detallan a los inhibidores del cotransportador sodio – glucosa 2 como una nueva familia considerados significativamente por parte de la comunidad científica debido a su capacidad para disminuir el riesgo cardio- renal y evitar complicaciones médicas. Conclusión: Los inhibidores del cotransportador sodio glucosa 2 brindan beneficios cardiovascular y renal quienes con mayor evidencia mediante un ensayo retrospectivo demuestra a canagliflozina rentaliza la enfermedad renal diabética haciendo factible utilizar en estos pacientes tomando en cuenta el criterio facultativo adoptando a la necesidad del paciente.

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A new era of diabetic kidney disease treatment with sodium–glucose cotransporter‐2 inhibitors

Abstract: SGLT2 inhibitors may have a potential to stop the decline of renal function independent of the stage of albuminuria in diabetic kidney disease, and can be a new light in the post‐RAS inhibitor era.

Cited by 5 publications

References 19 publications

Six-Month Periodic Fasting in Patients With Type 2 Diabetes and Diabetic Nephropathy: A Proof-of-Concept Study

Six-Month Periodic Fasting in Patients With Type 2 Diabetes and Diabetic Nephropathy: A Proof-of-Concept Study

Effectiveness and safety of sodium–glucose cotransporter 2 inhibitors in Asian populations

Efectividad del uso de inhibidores del cotransportador de sodio-glucosa 2 en la nefropatía diabética

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