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Can SGLT2 inhibitors help slow down kidney disease in patients with type 2 diabetes?

Posted by Medivizor on Jan 30, 2020 in Diabetes mellitus |


In a nutshell

This study investigated whether sodium-glucose cotransporter 2 (SGLT2) inhibitors could help slow down the progression of kidney disease in patients with type 2 diabetes (T2D). This study concluded that SGLT2 inhibitors slowed down kidney function decline compared to other anti-diabetes medications.

Some background

T2D often leads to long-term health complications, such as kidney disease (KD). This condition affects normal kidney function. If left untreated, KD can lead to other conditions, such as heart disease and kidney failure. Previous studies have shown that certain anti-diabetes medications can also help improve kidney problems. 

SGLT2 inhibitors such as dapagliflozin (Farxiga), empagliflozin (Jardiance), canagliflozin (Invokana), or ipragliflozin (Suglat) help the kidneys remove glucose from the body through the urine. Research suggests that these drugs may help kidney function in patients with T2D. Whether this benefit is observed in real-life outside of clinical trials is unclear.

Methods & findings

This study included the records of 65,321 patients with T2D with or without chronic KD. 35,561 patients started treatment with an SGLT2 inhibitor. The rest of the patients were started on another anti-diabetes medication, such as metformin (Glucophage). Patients were followed for an average of 14.9 months.

Kidney filtration rate refers to how well the kidneys are able to filter urine. This is used to measure kidney function and health. During follow-up, fewer patients in the SGLT2 group had a 50% decline in kidney filtration rate compared to patients on other medications (114 vs. 237). 

Compared to other treatments, starting an SGLT2 inhibitor treatment was associated with a 51% lower risk of poorer kidney function. The risk of developing early-stage KD also dropped by 67%. The risk of heart failure (40%) and mortality risk from any cause (45%) also decreased with SGLT2 inhibitor use.

The bottom line

This study concluded that SGLT2 inhibitors slowed down kidney function decline compared to other anti-diabetes medications. 

The fine print

This study was funded by AstraZeneca, the manufacturer of Farxiga.

Published By :

The lancet. Diabetes & endocrinology

Original Title :

Kidney outcomes associated with use of SGLT2 inhibitors in real-world clinical practice (CVD-REAL 3): a multinational observational cohort study.

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