Hannouneh Zein Alabdin, Cervantes C Elena, Hanouneh Mohamad, Atta Mohamed G
Faculty of Medicine, Al Andalus University for Medical Sciences, Tartus, Syria.
Division of Nephrology, Department of Medicine, Johns Hopkins University, Baltimore, MD, USA.
Glomerular Dis. 2025 Jan 23;5(1):119-132. doi: 10.1159/000543685. eCollection 2025 Jan-Dec.
Sodium-glucose cotransporter 2 inhibitors (SGLT2is) have significantly impacted the management of diabetic kidney disease (DKD) and heart failure (HF), providing benefits beyond glycemic control. This review examines the mechanisms through which SGLT2is provide renal and cardiovascular protection and assesses their clinical efficacy.
By inducing glucosuria and natriuresis, SGLT2is alleviate multiple complications induced by chronic hyperglycemia. Moreover, SGLT2is reduce albuminuria, improve tubular function, and modulate erythropoiesis. Additionally, they mitigate inflammation and fibrosis by decreasing oxidative stress and downregulating proinflammatory pathways. Clinical trials have demonstrated significant reductions in renal and cardiovascular events among patients with type 2 diabetes mellitus. A comprehensive review of the literature was conducted through PubMed, highlighting the effects of SGLT2is and the results of major clinical trials involving SGLT2is.
SGLT2is play a crucial role in the management of DKD and HF by addressing multiple pathogenic pathways. Currently, SGLT2is are included in clinical guidelines for DKD and HF management, and their benefits extend to nondiabetic populations. Further research is needed to explore SGLT2is' multifaceted mechanisms and potential applications across diverse patient populations and different disease etiologies.
钠-葡萄糖协同转运蛋白2抑制剂（SGLT2i）对糖尿病肾病（DKD）和心力衰竭（HF）的管理产生了重大影响，其益处超出了血糖控制范围。本综述探讨了SGLT2i提供肾脏和心血管保护的机制，并评估了它们的临床疗效。
通过诱导糖尿和利钠作用，SGLT2i减轻了慢性高血糖引起的多种并发症。此外，SGLT2i减少蛋白尿，改善肾小管功能，并调节红细胞生成。此外，它们通过降低氧化应激和下调促炎途径来减轻炎症和纤维化。临床试验表明，2型糖尿病患者的肾脏和心血管事件显著减少。通过PubMed对文献进行了全面综述，突出了SGLT2i的作用以及涉及SGLT2i的主要临床试验结果。
SGLT2i通过解决多种致病途径在DKD和HF的管理中发挥关键作用。目前，SGLT2i被纳入DKD和HF管理的临床指南，其益处扩展到非糖尿病人群。需要进一步研究以探索SGLT2i的多方面机制以及在不同患者群体和不同疾病病因中的潜在应用。
