Scheen Marc, Zanchi Anne, Martin Pierre-Yves, De Seigneux Sophie
Service de néphrologie, HUG, 1211 Genève 14.
Service d'endocrinologie, CHUV, 1011 Lausanne.
Rev Med Suisse. 2021 Feb 24;17(727):378-382.
SGLT2 inhibitors (SGLT2i) will change the clinical practice of nephrology with their therapeutic cardiorenal and antidiabetic properties. By inhibiting proximal tubular sodium and glucose reabsorption, these new drugs decrease intraglomerular pressures. Over the last 5 years several breakthrough studies have demonstrated the SGLT2i protective effects on outcomes such as cardiovascular mortality, hospital admission for heart failure, sustained decreases in eGFR in patients with diabetic nephropathy and the development of ESKD. With the new DAPA-CKD study revealing protective effects of SGLT2i in CKD patients without diabetes, therapeutic recommendations will now have to evolve towards including these drugs in the chronic management of all most proteinuric CKD patients.
钠-葡萄糖协同转运蛋白2抑制剂（SGLT2i）凭借其治疗心肾疾病和抗糖尿病的特性，将改变肾脏病学的临床实践。通过抑制近端肾小管对钠和葡萄糖的重吸收，这些新药可降低肾小球内压力。在过去5年中，多项突破性研究已证明SGLT2i对心血管死亡率、因心力衰竭住院、糖尿病肾病患者估算肾小球滤过率（eGFR）持续下降以及终末期肾病（ESKD）发生等结局具有保护作用。随着新的糖尿病肾病预后和进展评估（DAPA-CKD）研究揭示SGLT2i对非糖尿病CKD患者的保护作用，治疗建议现在将不得不朝着在所有大多数蛋白尿性CKD患者的慢性管理中纳入这些药物的方向发展。
