2019
DOI: 10.1016/s2213-8587(19)30256-6
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SGLT2 inhibitors for the prevention of kidney failure in patients with type 2 diabetes: a systematic review and meta-analysis

Abstract: This review summarises data from four studies including 38,723 participants across six continents.There was clear evidence that SGLT2 inhibitors reduce the risk dialysis, transplantation or death due to kidney disease, as well as a range of other major kidney outcomes, and that these agents also provide protection against acute kidney injury. Additionally, there were definitive, separate benefits at all levels of kidney function, including an approximate 30% proportional risk reduction in the composite kidney … Show more

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Cited by 679 publications
(626 citation statements)
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“…The mechanisms by which SGLT2 inhibitors preserve renal function in patients with diabetes have not been established, but the effect cannot be attributed to a glucose‐lowering action of these drugs. Intensive glycaemic control over 5–10 years has been shown to prevent the development of macroalbuminuria in patients with diabetes, but SGLT2 inhibitors have been shown to reduce the risk of end‐stage renal disease after only 2–3 years of treatment . Comparable or greater decreases in blood glucose produced by glucagon‐like peptide‐1 receptor agonists and dipeptidyl peptidase‐4 inhibitors administered for similar or longer periods of time are accompanied by no or only small benefits on the rate of decline in glomerular function and no reduction in the risk of major adverse renal outcomes, despite a decrease in albuminuria .…”
Section: Mechanisms That Are Unlikely To Explain the Renoprotective Ementioning
confidence: 99%
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“…The mechanisms by which SGLT2 inhibitors preserve renal function in patients with diabetes have not been established, but the effect cannot be attributed to a glucose‐lowering action of these drugs. Intensive glycaemic control over 5–10 years has been shown to prevent the development of macroalbuminuria in patients with diabetes, but SGLT2 inhibitors have been shown to reduce the risk of end‐stage renal disease after only 2–3 years of treatment . Comparable or greater decreases in blood glucose produced by glucagon‐like peptide‐1 receptor agonists and dipeptidyl peptidase‐4 inhibitors administered for similar or longer periods of time are accompanied by no or only small benefits on the rate of decline in glomerular function and no reduction in the risk of major adverse renal outcomes, despite a decrease in albuminuria .…”
Section: Mechanisms That Are Unlikely To Explain the Renoprotective Ementioning
confidence: 99%
“…By contrast, SGLT2 inhibitors have been hypothesized to decrease glomerular hyperfiltration by promoting afferent arteriolar vasoconstriction . Potentially because they act in complementary ways, SGLT2 inhibitors exert favourable effects on the diabetic kidney in patients who are already receiving inhibitors of the renin‐angiotensin system …”
Section: Are Sglt2 Inhibitors Renoprotective Through An Action To Inhmentioning
confidence: 99%
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“…Pooled summary estimates were calculated according to the random effects model, using the empirical Bayes method that, in Stata software, corresponds to the Paule-Mandel method [7]. In subgroup analysis, p-heterogeneity value lower than 0.1 was considered to reflect a high likelihood of difference beyond that expected by chance [8]. All analyses were done with Stata, version 16.0 (Stata Corp., College Station, TX).…”
Section: Open Accessmentioning
confidence: 99%
“…As to the effects of SGLT2 inhibitors in renal failure, there was a systematic review and meta-analysis of randomized, controlled, cardiovascular or kidney outcome trials [14]. From data of 2085 records, four studies had met the inclusion criteria.…”
mentioning
confidence: 99%