Inhibiteurs des SGLT2: focus sur le rein et la néphroprotection.

Diabetes Mellitus, Type 2/complications/drug therapy; Diabetic Nephropathies/drug therapy/prevention & control; Glomerular Filtration Rate; Humans; Kidney; Sodium-Glucose Transporter 2 Inhibitors/therapeutic use

Abstract :

[en] The relationships between sodium-glucose cotransporter type 2 inhibitors (SGLT2is) and kidney are complex: reduction of the glucose-lowering effect with the decline of glomerular filtration rate (GFR), biphasic effects on GFR along with treatment duration, low risk of acute kidney injury, rapid reduction of albuminuria, and, most importantly in clinical practice, a remarkable nephroprotection, with a decrease of the risk of end-stage renal disease or death from renal cause. This article describes the renal outcomes in the main clinical trials and analyses the impact of treatment with SGLT2is on renal prognosis according to different patient baseline characteristics. A nephroprotection is observed whatever the severity (even if GFR < 45 ml/min/1,73 m²) and type (with or without albuminuria, with or without diabetes) of renal disease.

Disciplines :

Urology & nephrology
Pharmacy, pharmacology & toxicology

Author, co-author :

Scheen, André ^✱; Université de Liège - ULiège > Département des sciences cliniques > Département des sciences cliniques

Delanaye, Pierre ^✱

^✱ These authors have contributed equally to this work.

Language :

French

Title :

Inhibiteurs des SGLT2: focus sur le rein et la néphroprotection.

Alternative titles :

[en] SGLT2 inhibitors: focus on kidneys and nephroprotection

Publication date :

2021

Journal title :

Revue Médicale Suisse

ISSN :

1660-9379

Publisher :

Medecine et Hygiène, Switzerland

Volume :

Issue :

747

Pages :

1397-1403

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 18 October 2021

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Bibliography

Scheen AJ. Sodium-glucose Co-Transporter Type 2 Inhibitors for the Treatment of Type 2 Diabetes Mellitus. Nature Rev Endocrinol 2020; 16:556-77.
Scheen AJ. Protection cardiorénale avec les inhibiteurs des SGLT2 : D EMPAREG OUTCOME à VERTIS CV. Rev Med Suisse 2020; 16:1483-8.
Scheen AJ, Paquot N. Traitement des patients diabétiques de type 2 à risque cardiorénal : ADA-EASD versus ESC. Rev Med Suisse 2020; 16:1478-82.
Scheen M, Zanchi A, Martin PY, et al. Inhibiteurs du SGLT2 dans les néphropathies diabétiques et non diabétiques. Rev Med Suisse 2021; 17:378-82.
Scheen AJ. Efficacy and Safety Profile of SGLT2 Inhibitors in Patients with Type 2 Diabetes and Chronic Kidney Disease. Expert Opin Drug Safety 2020; 19:243-56.
Baker ML, Perazella MA. SGLT2 Inhibitor Therapy in Patients with Type-2 Diabetes Mellitus: Is Acute Kidney Injury a Concern? J Nephrol 2020; 33:985-94.
Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int 2013; 3:1-150.
Scheen AJ. Pharmacodynamics, Efficacy and Safety of Sodium-Glucose Co-Transporter Type 2 (SGLT2) Inhibitors for the Treatment of Type 2 Diabetes Mellitus. Drugs 2015; 75:33-59.
Beaud F, Pruijm M, Humbert A, et al. Les inhibiteurs du cotransporteur SGLT2 comme nouveau traitement du diabète : Aspects rénaux. Rev Med Suisse 2015; 11:488-92.
Scheen AJ. Pharmacokinetics, Pharmacodynamics and Clinical Use of SGLT2 Inhibitors in Patients with Type 2 Diabetes Mellitus and Chronic Kidney Disease. Clin Pharmacokinet 2015; 54:691-708.
Heerspink HJL, Kosiborod M, Inzucchi SE, et al. Renoprotective Effects of Sodium-Glucose Cotransporter-2 Inhibitors. Kidney Int 2018; 94:26-39.
Heerspink HJL, Cherney DZI. Clinical Implications of an Acute Dip in Egfr after SGLT2 Inhibitor Initiation. Clin J Am Soc Nephrol 2021; CJN.02480221.
Bakris G, Oshima M, Mahaffey KW, et al. Effects of Canagliflozin in Patients with Baseline Egfr <30 Ml/Min Per 1.73 M(2): Subgroup Analysis of the Randomized CREDENCE Trial. Clin J Am Soc Nephrol 2020; 15:1705-14.
Kraus BJ, Weir MR, Bakris GL, et al. Characterization and Implications of the Initial Estimated Glomerular Filtration Rate « Dip » Upon Sodium-Glucose Cotransporter-2 Inhibition with Empagliflozin in the EMPA-REG OUTCOME Trial. Kidney Int 2021; 99:750-62.
Delanaye P, Scheen AJ. Preventing and Treating Kidney Disease in Patients with Type 2 Diabetes. Expert Opin Pharmacother 2019; 20:277-94.
Wanner C, Inzucchi SE, Lachin JM, et al. Empagliflozin and Progression of Kidney Disease in Type 2 Diabetes. N Engl J Med 2016; 375:323-34.
Perkovic V, de Zeeuw D, Mahaffey KW, et al. Canagliflozin and Renal Outcomes In Type 2 Diabetes: Results from the CANVAS Program Randomised Clinical Trials. Lancet Diabetes Endocrinol 2018; 6:691-704.
Mosenzon O, Wiviott SD, Cahn A, et al. Effects of Dapagliflozin on Development and Progression of Kidney Disease in Patients with Type 2 Diabetes: An Analysis from the DECLARE-TIMI 58 Randomised Trial. Lancet. Diabetes Endocrinol 2019; 7:606-17.
Cherney DZI, Charbonnel B, Cosentino F, et al. Effects of Ertugliflozin on Kidney Composite Outcomes, Renal Function and Albuminuria in Patients with Type 2 Diabetes Mellitus: An Analysis from the Randomised VERTIS CV Trial. Diabetologia 2021; 64:1256-67.
Scheen AJ, Delanaye P. Inhibiteurs des SGLT2 chez les patients avec insuffisance rénale chronique : Des essais cliniques aux recommandations et perspectives en pratique clinique. Rev Med Liège 2021; 76:186-94.
McMurray JJV, Solomon SD, Inzucchi SE, et al. Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction. N Engl J Med 2019; 381:1995-2008.
Packer M, Anker SD, Butler J, et al. Cardiovascular and Renal Outcomes with Empagliflozin in Heart Failure. N Engl J Med 2020; 383:1413-24.
Perkovic V, Jardine MJ, Neal B, et al. Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy. N Engl J Med 2019; 380:2295-306.
Scheen AJ. Canagliflozine et protection cardio-rénale chez le patient diabétique de type 2 : De CANVAS à CREDENCE. Rev Med Liège 2019; 4:508-13.
Heerspink HJL, Stefansson BV, Correa-Rotter R, et al. Dapagliflozin in Patients with Chronic Kidney Disease. N Engl J Med 2020; 383:1436-46.
Wheeler DC, Stefansson BV, Jongs N, et al. Effects of Dapagliflozin on Major Adverse Kidney and Cardiovascular Events in Patients with Diabetic and Non-Diabetic Chronic Kidney Disease: A Prespecified Analysis from the DAPA-CKD Trial. Lancet Diabetes Endocrinol 2021; 9:22-31.
Bhatt DL, Szarek M, Pitt B, et al. Sotagliflozin in Patients with Diabetes and Chronic Kidney Disease. N Engl J Med 2021; 384:129-39.
Scheen AJ, Lancellotti P. Inhibiteurs des SGLT2 : nouvelle option pour prévenir ou traiter l insuffisance cardiaque. Rev Med Liège 2021; 76:248-55.
Zannad F, Rossignol P. Cardiorenal Syndrome Revisited. Circulation 2018; 138:929-44.
McMurray JJV, Wheeler DC, Stefansson BV, et al. Effect of Dapagliflozin on Clinical Outcomes in Patients with Chronic Kidney Disease, with and without Cardiovascular Disease. Circulation 2021; 143:438-48.
Zelniker TA, Wiviott SD, Raz I, et al. SGLT2 Inhibitors for Primary and Secondary Prevention of Cardiovascular and Renal Outcomes in Type 2 Diabetes: A Systematic Review and Meta-Analysis of Cardiovascular Outcome Trials. Lancet 2019; 393:31-9.
Neuen BL, Young T, Heerspink HJL, et al. SGLT2 Inhibitors for the Prevention of Kidney Failure in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis. Lancet Diabetes Endocrinol 2019; 7:845-54.
Herrington WG, Preiss D, Haynes R, et al. The Potential for Improving Cardio-Renal Outcomes by Sodium-Glucose Co-Transporter-2 Inhibition in People with Chronic Kidney Disease: A Rationale for the EMPA-KIDNEY Study. Clin Kidney J 2018; 11:749-61.
Delanaye P, Wissing KM, Scheen AJ. SGLT2 Inhibitors: Renal Outcomes According to Baseline Albuminuria. Clin Kidney J 2021. Disponible sur : Academic. oup.com/ckj/advance-article/doi/10.1093/ckj/sfab096/6296592?guestAccessKey=ada 4e610-f4e1-4f42-a60d-10b2317f01ce (free access).
Levin A, Perkovic V, Wheeler DC, et al. Empagliflozin and Cardiovascular and Kidney Outcomes Across KDIGO Risk Categories: Post Hoc Analysis of a Randomized, Double-Blind, Placebo-Controlled, Multinational Trial. Clin J Am Soc Nephrol 2020; 15:1433-44.
Wanner C, Inzucchi SE, Zinman B, et al. Consistent Effects of Empagliflozin on Cardiovascular and Kidney Outcomes Irrespective of Diabetic Kidney Disease Categories: Insights from the EMPA-REG OUTCOME Trial. Diabetes Obes Metab 2020; 22:2335-47.
Neuen BL, Ohkuma T, Neal B, et al. Relative and Absolute Risk Reductions in Cardiovascular and Kidney Outcomes with Canagliflozin Across KDIGO Risk Categories: Findings from the CANVAS Program. Am J Kidney Dis 2021; 77:23-34.e1.
Scheen AJ, Paquot N. Une révolution dans le traitement du diabète de type 2 : Des antidiabétiques dotés d une protection cardio-rénale indépendamment du contrôle glycémique ! Rev Med Liège 2020; 75:392-8.
Heerspink HJ, Desai M, Jardine M, et al. Canagliflozin Slows Progression of Renal Function Decline Independently of Glycemic Effects. J Am Soc Nephrol 2017; 28:368-75.
Cooper ME, Inzucchi SE, Zinman B, et al. Glucose Control and the Effect of Empagliflozin on Kidney Outcomes in Type 2 Diabetes: An Analysis from the EMPA-REG OUTCOME Trial. Am J Kidney Dis 2019; 74:713-5.
Wheeler DC, Toto RD, Stefansson BV, et al. A Pre-Specified Analysis of the DAPA-CKD Trial Demonstrates the Effects of Dapagliflozin on Major Adverse Kidney Events in Patients with Iga Nephropathy. Kidney Int 2021; 100:215-24.
Kidney Disease: Improving Global Outcomes Diabetes Work G. KDIGO 2020 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease. Kidney Int 2020; 98:S1-115.
Tuttle KR, Brosius FC, 3rd, Cavender MA, et al. SGLT2 Inhibition for CKD and Cardiovascular Disease in Type 2 Diabetes: Report of a Scientific Workshop Sponsored by the National Kidney Foundation. Am J Kidney Dis 2021; 77:94-109.

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