Singh Prabhat, Goyal Lokesh, Mallick Deobrat C, Surani Salim R, Yashi Kanica
Department of Nephrology, Kidney Specialist of South Texas, 1521 S Staples St., Corpus Christi, TX 78403, USA.
Department of Internal Medicine, Christus Spohn Hospital, 600 Elizabeth St., Corpus Christi, TX 78403, USA.
J Clin Med. 2023 Sep 26;12(19):6202. doi: 10.3390/jcm12196202.
Diabetic kidney disease (DKD) causes a progressive decline in renal function, leading to end-stage kidney disease (ESKD), and increases the likelihood of cardiovascular events and mortality. The recent introduction of the sodium-glucose co-transporter 2 (SGLT-2) inhibitor has been a game changer in managing chronic kidney disease (CKD) and congestive heart failure (CHF). These agents not only slow down the progression of kidney disease but also have cardioprotective benefits, including for patients with congestive heart failure and atherosclerotic cardiovascular disease. Some evidence suggests that they can decrease the risk of stroke as well. This review aims to provide a comprehensive overview of the role of SGLT-2 inhibitors in CKD and CHF and their efficacy in stroke prevention. This review includes a comparison with glucagon-like peptide-1 (GLP-1) agonist and finerenone; focuses on safety data, the potential benefits beyond glycemic control, and a review of significant trials; and provides guidance in clinical practice.
糖尿病肾病（DKD）会导致肾功能进行性下降，最终发展为终末期肾病（ESKD），并增加心血管事件和死亡的可能性。最近引入的钠-葡萄糖协同转运蛋白2（SGLT-2）抑制剂在慢性肾脏病（CKD）和充血性心力衰竭（CHF）的管理方面带来了变革。这些药物不仅能减缓肾病进展，还具有心脏保护作用，对充血性心力衰竭和动脉粥样硬化性心血管疾病患者也有益处。一些证据表明，它们还能降低中风风险。本综述旨在全面概述SGLT-2抑制剂在CKD和CHF中的作用及其在预防中风方面的疗效。本综述包括与胰高血糖素样肽-1（GLP-1）激动剂和非奈利酮的比较；重点关注安全性数据、血糖控制以外的潜在益处以及重要试验的综述；并为临床实践提供指导。
