Use of gliflozins in nephrology: A narrative review
DOI:
https://doi.org/10.33448/rsd-v14i1.48032Keywords:
Chronic kidney disease; Nephrology; Review; Sodium-glucose co-transporter inhibitors.Abstract
For a long time, non-communicable chronic diseases suffered from a scarcity of therapies that could provide patients with a significant improvement in quality and life expectancy, as well as reduce the direct and indirect complications of their underlying clinical conditions. With the advent of SGLT2 inhibitors (sodium-glucose co-transporter 2 inhibitors), promising results have been found based on these objectives, including a paradigm shift in the natural course of chronic kidney disease and in the field of nephrology as a specialty. The aim of this study is to contribute as a tool for knowledge building on the topic, to describe some of its applications in medical practice, and additionally, to create space for filling gaps that have yet to be explored. For this purpose, a narrative literature review was conducted, containing articles and guidelines published and available in electronic databases over the last 10 years. After the selection of texts, it was possible to perceive the variety of applications and the current impact this class of medications has brought to clinical practice. Furthermore, after the production of the text, it is evident that many gaps still exist that can be filled and explored on the subject.
References
Anker, S. D., Butler, J., Filippatos, G., Ferreira, J. P., Bocchi, E., Böhm, M., Brunner-La Rocca, H. P., Choi, D. J., Chopra, V., Chuquiure-Valenzuela, E., Giannetti, N., Gomez-Mesa, J. E., Janssens, S., Januzzi, J. L., Gonzalez-Juanatey, J. R., Merkely, B., Nicholls, S. J., Perrone, S. V., Piña, I. L., Ponikowski, P., EMPEROR-Preserved Trial Investigators (2021). Empagliflozin in Heart Failure with a Preserved Ejection Fraction. The New England journal of medicine, 385(16), 1451– 1461. https://doi.org/10.1056/NEJMoa2107038
Bailey, C. J., Day, C., & Bellary, S. (2022). Renal protection with SGLT2 inhibitors: Effects in acute and chronic kidney disease. Current Diabetes Reports, 22(1), 39-52. https://doi.org/10.1007/s11892-021-01442-z
Carvalho, M., & Heilberg, I. P. (2024). Sodium-glucose cotranspor ter 2 (SGLT2) inhibitors in nephrolithiasis: should we "gliflozin" patients with kidney stone disease? Jornal brasileiro de nefrologia, 46(3), e20230146. https://doi.org/10.1590/2175-8239-JBN-2023-0146en
Cavalcante, L. T. C., & Oliveira, A. A. S. (2020). Métodos de revisão bibliográfica nos estudos científicos. Psicologia em Revista, 26(1), 83-102.
Dekkers, C. C. J., & Gansevoort, R. T. (2020). Sodium-glucose cotransporter 2 inhibitors: extending the indication to nondiabetic kidney disease?. Nephrology, dialysis, transplantation: official publication of the European Dialysis and Transplant Association - European Renal Association, 35(Suppl 1), i33–i42. https://doi.org/10.1093/ndt/gfz264
Ferreira, D. P. (2023). A importância da atenção em Nefrologia no Sistema Único de Saúde (SUS). Health Research Journal, 4(19), 876. https://doi.org/10.51723/hrj.v4i19.876.
Freitas, J., Francisco, J. T., Coimbra, M. T., Carvalho, R., Vilela, S., Silvano, J. L., Ribeiro, C., Malheiro, J., Pedroso, S., Almeida, M., Fonseca, I., & Martins, L. (2024). Sodium-glucose cotransporter 2 inhibitors in kidney transplant recipients – A retrospective single center study. Brazilian Journal of Transplantation, 27. https://doi.org/10.53855/bjt.v27i1.546_PORT
Garcia, J. N., & Oliveira, J. C. (2022). Revisão sobre o uso de inibidores de cotransportador sódio-glicose 2 e agonistas de peptídeo 1 em pessoas com diabetes mellitus tipo 2 e doença cardiovascular. Revista Brasileira de Medicina de Família e Comunidade, 17(44), 2428. https://doi.org/10.5712/rbmfc17(44)2428
González, V. (2021). Gliflozinas: más que antidiabéticos orales. Una breve revisión de la literatura. Revista Uruguaya de Cardiología, 36, e401. https://doi.org/10.29277/cardio.36.2.8
Heerspink, H. J. L., Stefánsson, B. V., Correa-Rotter, R., Chertow, G. M., Greene, T., Hou, F. F., Mann, J. F. E., McMurray, J. J. V., Lindberg, M., Rossing, P., Sjöström, C. D., Toto, R. D., Langkilde, A. M., Wheeler, D. C., & DAPA-CKD Trial Committees and Investigators (2020). Dapagliflozin in Patients with Chronic Kidney Disease. The New England journal of medicine, 383(15), 1436–1446. https://doi.org/10.1056/NEJMoa2024816
Inserra, F., Forte, E., Elbert, A., Waisman, G., & Castellaro, C. (2023). Position statement: Effect of SGLT2 inhibitors on blood pressure, vascular damage, kidney disease, and associated cardiovascular risk. Revista de la Sociedad Argentina de Diabetes, 57(140-158).
Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group (2024). KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney international, 105(4S), S117–S314. https://doi.org/10.1016/j.kint.2023.10.018
Kim, N. H., & Kim, N. H. (2022). Renoprotective mechanism of sodium-glucose cotransporter 2 inhibitors: Focusing on renal hemodynamics. Diabetes & Metabolism Journal, 46, 543-551. https://doi.org/10.4093/dmj.2022.0209
Koh, E. S., Kim, G.-H., & Chung, S. (2023). Intrarenal mechanisms of sodium-glucose cotransporter-2 inhibitors on tubuloglomerular feedback and natriuresis. Endocrinology and Metabolism, 38, 359-372. https://doi.org/10.3803/EnM.2023.1764
Ministério da Saúde, Secretaria de Vigilância em Saúde e Ambiente. (2024). Boletim epidemiológico (Vol. 55, N.º 12, 11 set.). https://www.gov.br/saude/pt-br.
Neal, B., Perkovic, V., & Matthews, D. R. (2017). Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes. The New England journal of medicine, 377(21), 2099. https://doi.org/10.1056/NEJMc1712572
Perkovic, V., Jardine, M. J., Neal, B., Bompoint, S., Heerspink, H. J. L., Charytan, D. M., Edwards, R., Agarwal, R., Bakris, G., Bull, S., Cannon, C. P., Capuano, G., Chu, P. L., de Zeeuw, D., Greene, T., Levin, A., Pollock, C., Wheeler, D. C., Yavin, Y., Zhang, H., … CREDENCE Trial Investigators (2019). Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy. The New England journal of medicine, 380(24), 2295–2306. https://doi.org/10.1056/NEJMoa1811744
Rodrigues, M. F., Vieira de Melo, N. C., & Sousa da Silva, L. C. (2024). Antiproteinuric effect of sodium glucose cotransporter type 2 inhibitors in patients with IgA nephropathy: Case report and literature review. Brazilian Journal of Health Review, 7(1), 5478-5486. https://doi.org/10.34119/bjhrv7n1-444
Schietzel, S., Bally, L., Cereghetti, G., Faller, N., Moor, M. B., Vogt, B., Rintelen, F., Trelle, S., & Fuster, D. (2022). Impact of the SGLT2 inhibitor empagliflozin on urinary supersaturations in kidney stone formers (SWEETSTONE trial): protocol for a randomised, double-blind, placebo-controlled cross-over trial. BMJ open, 12(3), e059073. https://doi.org/10.1136/bmjopen2021-059073
Sridhar, V. S., Dubrofsky, L., Boulet, J., & Cherney, D. Z. (2020). Making a case for the combined use of SGLT2 inhibitors and GLP1 receptor agonists for cardiorenal protection. Brazilian Journal of Nephrology (Jornal Brasileiro de Nefrologia), 42(4), 467-477. https://doi.org/10.1590/2175-8239/JBN-2020-0100
Tavares, N. U., Luiza, V. L., Oliveira, M. A., Costa, K. S., Mengue, S. S., Arrais, P. S. D., et al. (2016). Acesso gratuito a medicamentos para tratamento de doenças crônicas no Brasil. Revista de Saúde Pública, 50(supl 2), 7s.
Yen, F. S., Wang, S. I., Hsu, C. C., Hwu, C. M., & Wei, J. C. (2024). Sodium-Glucose Cotransporter-2 Inhibitors and Nephritis Among Patients With Systemic Lupus Erythematosus. JAMA network open, 7(6), e2416578. https://doi.org/10.1001/jamanetworkopen.2024.16578
Zannad, F., Ferreira, J. P., Pocock, S. J., Anker, S. D., Butler, J., Filippatos, G., Brueckmann, M., Ofstad, A. P., Pfarr, E., Jamal, W., & Packer, M. (2020). SGLT2 inhibitors in patients with heart failure with reduced ejection fraction: a meta-analysis of the EMPEROR-Reduced and DAPA-HF trials. Lancet (London, England), 396(10254), 819–829. https://doi.org/10.1016/S0140-6736(20)31824-9
Zinman, B., Wanner, C., Lachin, J. M., Fitchett, D., Bluhmki, E., Hantel, S., Mattheus, M., Devins, T., Johansen, O. E., Woerle, H. J., Broedl, U. C., Inzucchi, S. E., & EMPA-REG OUTCOME Investigators (2015). Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes. The New England journal of medicine, 373(22), 2117–2128. https://doi.org/10.1056/NEJMoa1504720
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