Dharia Atit, Khan Abid, Sridhar Vikas S, Cherney David Z I
Division of Nephrology, Department of Medicine, University Health Network, Toronto, Ontario, Canada; email:
Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
Annu Rev Med. 2023 Jan 27;74:369-384. doi: 10.1146/annurev-med-042921-102135.
Sodium-glucose cotransporter-2 inhibitors (SGLT2 inhibitors) were originally developed as antidiabetic agents, with cardiovascular (CV) outcome trials demonstrating improved CV outcomes in patients with type 2 diabetes mellitus (T2D). Secondary analyses of CV outcome trials and later dedicated kidney outcome trials consistently reported improved kidney-related outcomes independent of T2D status and across a range of kidney function and albuminuria. Importantly, SGLT2 inhibitors are generally safe and well tolerated, with clinical trials and real-world analyses demonstrating a decrease in the risk of acute kidney injury. The kidney protective effects of SGLT2 inhibitors generally extend across different members of the class, possibly on the basis of hemodynamic, metabolic, anti-inflammatory, and antifibrotic mechanisms. In this review, we summarize the effects of SGLT2 inhibitors on kidney outcomes in diverse patient populations.
钠-葡萄糖协同转运蛋白2抑制剂（SGLT2抑制剂）最初作为抗糖尿病药物研发，心血管（CV）结局试验表明其可改善2型糖尿病（T2D）患者的CV结局。CV结局试验的二次分析以及后来专门的肾脏结局试验一致报告称，无论T2D状态如何，在一系列肾功能和蛋白尿范围内，与肾脏相关的结局均得到改善。重要的是，SGLT2抑制剂总体上安全且耐受性良好，临床试验和真实世界分析表明急性肾损伤风险降低。SGLT2抑制剂的肾脏保护作用通常在该类药物的不同成员中均有体现，可能基于血流动力学、代谢、抗炎和抗纤维化机制。在本综述中，我们总结了SGLT2抑制剂对不同患者群体肾脏结局的影响。
