Department of Nephrology, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Department of General Pediatrics, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Nephrology (Carlton). 2022 Feb;27(2):126-132. doi: 10.1111/nep.13979. Epub 2021 Sep 26.
Sodium-glucose cotransporter-2 (SGLT2) inhibitors represent novel hypoglycemic drugs for the treatment of adult diabetes that have shown considerable potential for cardioprotection and renoprotection. This new drug can inhibit SGLT2 at the proximal tubule, increase glucosuria and natriuresis, and thus decreases the serum glucose level and blood pressure. Furthermore, the tubuloglomerular feedback activated by the natriuresis can decrease glomerular hyperfiltration, acknowledged as the main foundation of renoprotection. Several studies have confirmed the protective effects of SGLT2 inhibitors on the kidneys of adult diabetic patients and those with non-diabetic nephropathy; however, limited researches are seen in paediatric patients. In this review, we have summarized the mechanisms of action of SGLT2 inhibitors, the current experiences in adults, results of exploratory studies in children, and adverse events & obstacles of paediatric use. We further explore the potential and possible future research direction of SGLT2 inhibitors in paediatric diseases.
钠-葡萄糖共转运蛋白 2（SGLT2）抑制剂是一种新型的治疗成人糖尿病的降血糖药物，具有显著的心脏和肾脏保护作用。这种新药可以抑制近曲小管中的 SGLT2，增加尿葡萄糖和尿钠排泄，从而降低血清葡萄糖水平和血压。此外，通过尿钠排泄激活的管球反馈可以减少肾小球高滤过，这被认为是肾脏保护的主要基础。几项研究证实了 SGLT2 抑制剂对成年糖尿病患者和非糖尿病肾病患者肾脏的保护作用，但在儿科患者中研究有限。在这篇综述中，我们总结了 SGLT2 抑制剂的作用机制、在成人中的现有经验、在儿童中的探索性研究结果以及儿科应用的不良反应和障碍。我们进一步探讨了 SGLT2 抑制剂在儿科疾病中的潜在应用和可能的未来研究方向。
