Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital

The renal hemodynamic effects of the SGLT2 inhibitor dapagliflozin are caused by post-glomerular vasodilatation rather than pre-glomerular vasoconstriction in metformin-treated patients with type 2 diabetes in the randomized, double-blind RED trial

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review


  1. Cost-effectiveness of lipid lowering with statins and ezetimibe in chronic kidney disease

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Improvements in albuminuria and chronic kidney disease progression with the appetite suppressant lorcaserin

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Challenges and opportunities for nephrology in Western Europe

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Arterial oxygen content regulates plasma erythropoietin independent of arterial oxygen tension: a blinded crossover study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  • Erik J M van Bommel
  • Marcel H A Muskiet
  • Michaël J B van Baar
  • Lennart Tonneijck
  • Mark M Smits
  • Anna L Emanuel
  • Andrea Bozovic
  • A H Jan Danser
  • Frank Geurts
  • Ewout J Hoorn
  • Daan J Touw
  • Emil L Larsen
  • Henrik E Poulsen
  • Mark H H Kramer
  • Max Nieuwdorp
  • Jaap A Joles
  • Daniël H van Raalte
Vis graf over relationer

Sodium-glucose cotransporter 2 inhibitors (SGLT2i) improve hard renal outcomes in type 2 diabetes. This is possibly explained by the fact that SGLT2i normalize the measured glomerular filtration rate (mGFR) by increasing renal vascular resistance, as was shown in young people with type 1 diabetes and glomerular hyperfiltration. Therefore, we compared the renal hemodynamic effects of dapagliflozin with gliclazide in type 2 diabetes. The mGFR and effective renal plasma flow were assessed using inulin and para-aminohippurate clearances in the fasted state, during clamped euglycemia (5 mmol/L) and during clamped hyperglycemia (15 mmol/L). Filtration fraction and renal vascular resistance were calculated. Additionally, factors known to modulate renal hemodynamics were measured. In 44 people with type 2 diabetes on metformin monotherapy (Hemoglobin A1c 7.4%, mGFR 113 mL/min), dapagliflozin versus gliclazide reduced mGFR by 5, 10, and 12 mL/min in the consecutive phases while both agents similarly improved Hemoglobin A1c (-0.48% vs -0.65%). Dapagliflozin also reduced filtration fraction without increasing renal vascular resistance, and increased urinary adenosine and prostaglandin concentrations. Gliclazide did not consistently alter renal hemodynamic parameters. Thus, beyond glucose control, SGLT2i reduce mGFR and filtration fraction in type 2 diabetes. The fact that renal vascular resistance was not increased by dapagliflozin suggests that this is due to post-glomerular vasodilation rather than pre-glomerular vasoconstriction.

TidsskriftKidney International
Udgave nummer1
Sider (fra-til)202-212
Antal sider11
StatusUdgivet - 1 jan. 2020

Bibliografisk note

Copyright © 2019 International Society of Nephrology. All rights reserved.

ID: 58541932