[Antidiabetic SGLT-2 inhibitors prevent progression of chronic kidney disease].

Several interventional trials that studied cardiovascular safety of antidiabetic drugs in patients with diabetes mellitus and elevated risk of cardiovascular disease suggested potential nephroprotective effects of SGLT-2 inhibitors. Subsequently, the CREDENCE study confirmed reduced progression of chronic kidney disease (CKD) towards dialysis-dependency in diabetic patients with mildly or moderately impaired glomerular filtration rate and high albuminuria. Next, the DAPA-CKD and EMPA-KIDNEY studies were initiated to test whether SGLT-2-inhibitors will also affect CKD progression in (a) non-diabetic CKD patients, (b) in CKD patients without albuminuria and/or (c) in patients with advanced CKD. The premature stop of DAPA-CKD was announced in March 2020 because of overwhelming nephroprotective effects of dapagliflozin. The final publication of DAPA-CKD is expected in late 2020. Parallelly, new treatment guidelines from the Kidney-Disease:-Improving-Global-Outcomes (KDIGO)-Initiative will recommend SGLT-2 inhibitors as standard treatment for CKD patients with diabetes mellitus, even though these drugs are not yet licensed for patients with moderately-to-severely reduced renal function.