Sodium Glucose Cotransporter 2 Inhibition in the Diabetic Kidney

An Update

Aleksandra Novikov; Volker Vallon


Curr Opin Nephrol Hypertens. 2016;25(1):50-58. 

In This Article


SGLT2 inhibitors induce a multitude of effects in the diabetic setting that have the potential to affect the progression of the primary disease as well as its cardiovascular consequences, including beneficial effects on blood glucose, body weight, body fat, pancreatic β cells, glomerular hyperfiltration, kidney growth and inflammation, and hypertension, associated with little risk for hypoglycemia. New studies provided further mechanistic clues, but also indicated the need to better understand the nuances of SGLT2 inhibition, including effects on the outer medulla, in PCKD as well as their potential for ketoacidosis. In addition to EMPA-REG OUTCOME, there are several studies underway looking at the effects of SGLT2 inhibition on cardiovascular and kidney outcomes including DECLARE (Multicenter Trial to Evaluate the Effect of Dapagliflozin on the Incidence of Cardiovascular Events), CANVAS (Canagliflozin Cardiovascular Assessment Study), and CREDENCE (Evaluation of the Effects of Canagliflozin on Renal and Cardiovascular Outcomes in Participants With Diabetic Nephropathy) (for review see[3]). Their results will come out in the next few years, complement the results from EMPA-REG OUTCOME, and help to further refine our understanding of the therapeutic potential and safety of SGLT2 inhibition.