Saraswati Laksmi Dewi, Putu Ayunda Trisnia

Sodium-Glucose Co-Transporter 2 Inhibitors: A Review of the New Paradigm in Chronic Kidney Disease Management

Introduction

Sodium-glucose co-transporter 2 inhibitors: a review of the new paradigm in chronic kidney disease management. SGLT2 inhibitors revolutionize chronic kidney disease (CKD) management, improving kidney function, reducing proteinuria & cardiovascular risks, even in non-diabetic patients.

Abstract

Sodium-glucose cotransporter 2 (SGLT2) inhibitors are revolutionising the management of chronic kidney disease (CKD), delivering substantial benefits that extend far beyond mere glycemic control for patients with diabetes. This review underscores the compelling mechanisms by which SGLT2 inhibitors enhance kidney function, effectively reduce proteinuria, and significantly lower the risk of cardiovascular events. Robust evidence from major clinical trials showcases their ability to slow the progression of CKD and dramatically improve overall patient outcomes, even in those without diabetes. For example, in the DAPA-CKD trial, dapagliflozin reduced the risk of the composite renal outcome by 39% (HR 0.61, 95% CI 0.51–0.72), while empagliflozin in EMPA-KIDNEY lowered the risk of CKD progression or cardiovascular death by 28% (HR 0.72, 95% CI 0.64–0.82). While challenges remain in applying these treatments to advanced stages of chronic kidney disease (CKD) and the importance of meticulous patient selection, ongoing research is poised to refine treatment strategies and unlock the full potential of SGLT2 inhibitors in the management of CKD. These therapies offer a significant clinical impact and represent a promising avenue toward elevating the standard of care for patients with this challenging condition.

Review

The review "Sodium-Glucose Co-Transporter 2 Inhibitors: A Review of the New Paradigm in Chronic Kidney Disease Management" provides a timely and pertinent overview of the evolving role of SGLT2 inhibitors. The abstract effectively conveys the revolutionary impact of these agents, highlighting their benefits extending well beyond glycemic control to encompass substantial improvements in kidney function, reduction in proteinuria, and significant lowering of cardiovascular risk. The authors articulate a compelling case for a paradigm shift in CKD management, emphasizing the robust evidence base that underpins the widespread adoption of SGLT2 inhibitors. A key strength of the abstract lies in its clear presentation of quantitative data from pivotal clinical trials such as DAPA-CKD and EMPA-KIDNEY. Citing a 39% reduction in composite renal outcomes with dapagliflozin and a 28% reduction in CKD progression or cardiovascular death with empagliflozin provides concrete evidence of their efficacy and underscores their ability to slow CKD progression and improve overall patient outcomes, even in individuals without diabetes. This focus on verifiable trial results significantly strengthens the review's assertion of SGLT2 inhibitors as a cornerstone therapy in modern nephrology. While the abstract robustly details the current achievements, it also judiciously acknowledges ongoing challenges, particularly concerning the application of these treatments in advanced stages of CKD and the critical importance of meticulous patient selection. This balanced perspective, coupled with a forward-looking view on ongoing research, suggests the review will effectively guide clinicians and researchers toward refining treatment strategies. Ultimately, the abstract successfully positions SGLT2 inhibitors as a transformative and promising avenue for elevating the standard of care for patients suffering from this challenging condition.

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