Which medications in the drug class Sodium-Glucose Transporter-2 (SGLT2) Inhibitors are used in the treatment of Chronic Kidney Disease (CKD)?

Updated: Jul 21, 2021
  • Author: Pradeep Arora, MD; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

Sodium-Glucose Transporter-2 (SGLT2) Inhibitors

Sodium-glucose cotransporter 2 (SGLT2), expressed in the proximal renal tubules, is responsible for the majority of the reabsorption of filtered glucose from the tubular lumen. Inhibition of SGLT2 reduces reabsorption of filtered glucose and thereby promotes urinary glucose excretion. 

Inhibition of SGLT also reduces sodium reabsorption and increases the delivery of sodium to the distal tubule. This may influence several physiological functions including, but not restricted to, lowering both pre- and afterload of the heart and downregulation of sympathetic activity, and decreased intraglomerular pressure, which is mediated by increased tubuloglomerular feedback.

Dapagliflozin (Farxiga)

Indicated to reduce risk of sustained eGFR decline, ESKD, cardiovascular death, and hospitalization for heart failure in adults with CKD who are at risk of progression.

Canagliflozin (Invokana)

Indicated to reduce the risk of ESKD, doubling of serum creatinine, cardiovascular death, and hospitalization for heart failure in adults with type 2 diabetes mellitus and diabetic nephropathy with albuminuria. 


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