Retrospective Analysis of the Renoprotective Effects of Long-Term Use of Six Types of Sodium–Glucose Cotransporter 2 Inhibitors in Japanese Patients with Type 2 Diabetes Mellitus and Chronic Kidney Disease

J of Clinical Hypertension

et al. 2020

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Sodium-glucose cotransporter 2 inhibitors (SGLT2Is) are novel oral hypoglycemic agents that increase the urinary excretion of glucose by the inhibition of SGLT2 in the renal proximal tubules. The loss of calories in the form of urinary glucose excretion results in the loss of body weight (BW) and in pleiotropic effects, such as a decrease in blood pressure (BP) and improvements in dyslipidemia or liver function. 1 These pleiotropic effects of SGLT2Is are drawing attention for the treatment of diabetes mellitus (DM) patients. Some large-scale trials, such as the EMPA-REG OUTCOME trial, 2 CANVAS/CANVAS-R program, 3 and DECLARE-TIMI58, 4 that investigated the effects of SGLT2Is on cardiovascular outcomes revealed significant improvements in cardiovascular events and even in diabetic nephropathy in

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Section: Introductionsupporting

confidence: 69%

Section: Methodsmentioning

confidence: 99%

“…Multiple linear regression analysis was performed in 763 patients, whose clinical backgrounds were described in our previous study. 6 The independent predictors of ΔMAP were identified…”

Section: Independent Predictors Of δMap At the Office By Using Multmentioning

confidence: 99%

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confidence: 99%

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The influence of long‐term administration of SGLT2 inhibitors on blood pressure at the office and at home in patients with type 2 diabetes mellitus and chronic kidney disease

Furuki

J of Clinical Hypertension

et al. 2020

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“…Two Japanese studies 10 , 11 reported that SGLT2 inhibitors have favorable effects on the urine albumin‐to‐creatinine ratios (ACRs) of type 2 diabetes mellitus patients with chronic kidney disease (CKD). In addition, we previously showed that blood pressure (BP) management during SGLT2 inhibitor treatment is correlated with ACR improvement 12 .…”

Section: Introductionmentioning

confidence: 99%

Sodium–glucose cotransporter 2 inhibitor‐induced reduction in the mean arterial pressure improved renal composite outcomes in type 2 diabetes mellitus patients with chronic kidney disease: A propensity score‐matched model analysis in Japan

Hatori

et al. 2021

J of Diabetes Invest

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Aims/Introduction Large‐scale clinical trials have reported that, in patients with type 2 diabetes mellitus, sodium–glucose cotransporter 2 (SGLT2) inhibitor treatment affords favorable renal outcomes; the underlying mechanisms, however, remain unclear. Thus, this study investigated how SGLT2 inhibitor‐induced changes in the mean arterial pressure (MAP; denoted as ΔMAP) are associated with renal outcomes in type 2 diabetes mellitus patients with chronic kidney disease (CKD). Materials and Methods We retrospectively assessed the data of 624 Japanese type 2 diabetes mellitus patients with CKD who had been using SGLT2 inhibitors for >1 year. For propensity score matching (1:1 nearest neighbor match, with caliper value = 0.053, no replacement), patients were categorized into two groups based on the ΔMAP (>−4 mmHg [n = 329] and ≤−4.0 mmHg [n = 295]). Composite albuminuria progression or a ≥15% annual reduction in the estimated glomerular filtration rate was regarded as the end‐point. Results Per group, 173 propensity‐matched patients were compared. Patients with ΔMAP ≤−4 mmHg had a significantly lower incidence of composite renal outcomes than those with ΔMAP ≥−4 mmHg (5.8% [n = 10] vs 15.6% [n = 27], P = 0.003). Although the between‐group differences in the estimated glomerular filtration rates were non‐significant, patients with a ΔMAP ≤−4 mmHg had significantly larger reductions in the logarithmic urine albumin‐to‐creatinine ratio (P = 0.005). Conclusions The degree of blood pressure reduction after SGLT2 inhibitor treatment influenced renal composite outcomes in Japanese type 2 diabetes mellitus patients with CKD, confirming the importance of blood pressure management in type 2 diabetes mellitus patients with CKD, even when they are under SGLT2 inhibitor treatment.

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Comparison of renal outcomes between sodium glucose co-transporter 2 inhibitors and glucagon-like peptide 1 receptor agonists

Diabetes Research and Clinical Practice

Hatori

et al. 2022