Nephrology and Dialysis Unit, Department of Advanced Medical and Surgical Sciences, University Vanvitelli, Naples, Italy.
Renal Division, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy.
J Nephrol. 2022 Jul;35(6):1605-1618. doi: 10.1007/s40620-022-01336-7. Epub 2022 May 18.
Chronic kidney disease (CKD) is a global health problem, affecting more than 850 million people worldwide. The number of patients receiving renal replacement therapy (dialysis or renal transplantation) has increased over the years, and it has been estimated that the number of people receiving renal replacement therapy will more than double from 2.618 million in 2010 to 5.439 million in 2030, with wide differences among countries. The main focus of CKD treatment has now become preserving renal function rather than replacing it. This is possible, at least to some extent, through the optimal use of multifactorial therapy aimed at preventing end-stage kidney disease and cardiovascular events. Sodium/glucose cotransporter 2 inhibitors (SGLT2i) reduce glomerular hypertension and albuminuria with beneficial effects on progression of renal damage in both diabetic and non-diabetic CKD. SGLT2 inhibitors also show great benefits in cardiovascular protection, irrespective of diabetes. Therefore, the use of these drugs will likely be extended to the whole CKD population as a new standard of care.
慢性肾脏病（CKD）是一个全球性的健康问题，影响着全球超过 8.5 亿人。接受肾脏替代治疗（透析或肾移植）的患者人数多年来一直在增加，据估计，到 2030 年，接受肾脏替代治疗的人数将从 2010 年的 261.8 万人增加一倍以上，达到 543.9 万人，各国之间存在着巨大差异。CKD 治疗的主要重点现在已经变成了保护肾功能，而不是替代它。这是可能的，至少在一定程度上，通过优化多因素治疗，旨在预防终末期肾病和心血管事件。钠/葡萄糖共转运蛋白 2 抑制剂（SGLT2i）可降低肾小球高血压和白蛋白尿，对糖尿病和非糖尿病 CKD 的肾脏损害进展有有益作用。SGLT2 抑制剂在心血管保护方面也有很大益处，与糖尿病无关。因此，这些药物的使用可能会扩展到整个 CKD 人群，作为一种新的治疗标准。
