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SGLT2 Inhibition for CKD and Cardiovascular Disease in Type 2 Diabetes: Report of a Scientific Workshop Sponsored by the National Kidney Foundation

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  1. SKAP2, a Candidate Gene for Type 1 Diabetes, Regulates β-Cell Apoptosis and Glycaemic Control in Newly Diagnosed Patients

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  2. Integrating Longitudinal Clinical and Baseline Multiomics Data for Predicting C-Peptide Progression in Newly Diagnosed Type 1 Diabetes

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  1. Metformin and carotid intima-media thickness in never-smokers with type 1 diabetes: The REMOVAL trial

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  2. Non-invasive assessment of temporal changes in myocardial microvascular function in persons with type 2 diabetes and healthy controls

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  3. Persons with type 1 diabetes have low blood oxygen levels in the supine and standing body positions

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  4. The effect of liraglutide and sitagliptin on oxidative stress in persons with type 2 diabetes

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  5. Genome-Wide Association Study of Circulating Interleukin 6 Levels Identifies Novel Loci

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  • Katherine R Tuttle
  • Frank C Brosius
  • Matthew A Cavender
  • Paola Fioretto
  • Kevin J Fowler
  • Hiddo J L Heerspink
  • Tom Manley
  • Darren K McGuire
  • Mark E Molitch
  • Amy K Mottl
  • Leigh Perreault
  • Sylvia E Rosas
  • Peter Rossing
  • Laura Sola
  • Volker Vallon
  • Christoph Wanner
  • Vlado Perkovic
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Diabetes is the most frequent cause of chronic kidney disease (CKD), leading to nearly half of all cases of kidney failure requiring replacement therapy. The principal cause of death among patients with diabetes and CKD is cardiovascular disease (CVD). Sodium/glucose cotransporter 2 (SGLT2) inhibitors were developed to lower blood glucose levels by inhibiting glucose reabsorption in the proximal tubule. In clinical trials designed to demonstrate the CVD safety of SGLT2 inhibitors in type 2 diabetes mellitus (T2DM), consistent reductions in risks for secondary kidney disease end points (albuminuria and a composite of serum creatinine doubling or 40% estimated glomerular filtration rate decline, kidney failure, or death), along with reductions in CVD events, were observed. In patients with CKD, the kidney and CVD benefits of canagliflozin were established by the CREDENCE (Canagliflozin and Renal Events in Diabetes With Established Nephropathy Clinical Evaluation) trial in patients with T2DM, urinary albumin-creatinine ratio >300 mg/g, and estimated glomerular filtration rate of 30 to <90 mL/min/1.73 m2 To clarify and support the role of SGLT2 inhibitors for treatment of T2DM and CKD, the National Kidney Foundation convened a scientific workshop with an international panel of more than 80 experts. They discussed the current state of knowledge and unanswered questions in order to propose therapeutic approaches and delineate future research. SGLT2 inhibitors improve glomerular hemodynamic function and are thought to ameliorate other local and systemic mechanisms involved in the pathogenesis of CKD and CVD. SGLT2 inhibitors should be used when possible by people with T2DM to reduce risks for CKD and CVD in alignment with the clinical trial entry criteria. Important risks of SGLT2 inhibitors include euglycemic ketoacidosis, genital mycotic infections, and volume depletion. Careful consideration should be given to the balance of benefits and harms of SGLT2 inhibitors and risk mitigation strategies. Effective implementation strategies are needed to achieve widespread use of these life-saving medications.

Original languageEnglish
Issue number1
Pages (from-to)1-16
Number of pages16
Publication statusPublished - Jan 2021

ID: 61434418