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Erschienen in: Wiener klinische Wochenschrift 3-4/2023

17.10.2022 | review article

Value of SGLT-2 inhibitors in the treatment of chronic kidney disease

Clinical and practical implications

verfasst von: Marcus Säemann, Daniel Cejka, Sabine Schmaldienst, Alexander R. Rosenkranz, Gert Mayer

Erschienen in: Wiener klinische Wochenschrift | Ausgabe 3-4/2023

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Summary

Chronic kidney disease (CKD) drastically increases the risk for cardiovascular morbidity and mortality and its worldwide prevalence is still rising. Effective treatment slows CKD progression, prevents development of end-stage kidney disease and cardiovascular disease thereby prolonging survival of patients. Recently, several large-scale studies with sodium-glucose cotransport‑2 inhibitors (SGLT-2i) have demonstrated profound nephroprotective and cardioprotective properties in patients with type 2 diabetes mellitus with both CKD and heart failure. Recently, the dapagliflozin and prevention of adverse outcomes in chronic kidney disease (DAPA-CKD) trial demonstrated that the selective SGLT-2i dapagliflozin reduced the hazard ratio for a composite renal and cardiovascular death endpoint in patients with CKD with or without type 2 diabetes. Furthermore, dapagliflozin exerted strong nephroprotection in CKD patients with diverse etiologies like IgA nephropathy. Furthermore, other promising CKD trials such as with empagliflozin are underway. Hence, individualized treatment with SGLT2i represents a promising therapeutic option for patients with both diabetic and non-diabetic CKD. Here we summarize the current knowledge on the treatment with SGLT-2i in CKD patients underscoring a strong rationale for SGLT2 inhibition to be incorporated into standard of care for most CKD patients also with non-diabetic kidney disease. Finally, we aim to translate the current evidence into recommendations for the clinical practice in the management of patients with CKD.
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Metadaten
Titel
Value of SGLT-2 inhibitors in the treatment of chronic kidney disease
Clinical and practical implications
verfasst von
Marcus Säemann
Daniel Cejka
Sabine Schmaldienst
Alexander R. Rosenkranz
Gert Mayer
Publikationsdatum
17.10.2022
Verlag
Springer Vienna
Erschienen in
Wiener klinische Wochenschrift / Ausgabe 3-4/2023
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI
https://doi.org/10.1007/s00508-022-02096-x

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