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Review
. 2021 Mar;26(2):337-345.
doi: 10.1007/s10741-020-10024-2. Epub 2020 Sep 8.

Renal protection: a leading mechanism for cardiovascular benefit in patients treated with SGLT2 inhibitors

Davide Margonato  1   2 , Giuseppe Galati  3 , Simone Mazzetti  4 , Rosa Cannistraci  5 , Gianluca Perseghin  5 , Alberto Margonato  3 , Andrea Mortara  4
Affiliations
Free PMC article
Review

Renal protection: a leading mechanism for cardiovascular benefit in patients treated with SGLT2 inhibitors

Davide Margonato et al. Heart Fail Rev. 2021 Mar.
Free PMC article

Abstract

Initially developed as glucose-lowering drugs, sodium-glucose co-transporter type 2 inhibitors (SGLT2i) have demonstrated to be effective agents for the risk reduction of cardiovascular (CV) events in patients with type 2 diabetes mellitus (T2DM). Subsequently, data has emerged showing a significant CV benefit in patients treated with SGLT2i regardless of diabetes status. Renal protection has been initially evaluated in CV randomized trials only as secondary endpoints; nonetheless, the positive results gained have rapidly led to the evaluation of nephroprotection as primary outcome in the CREDENCE trial. Different renal and vascular mechanisms can account for the CV and renal benefits enlightened in recent literature. As clinical guidelines rapidly evolve and the role of SGLT2i appears to become pivotal for CV, T2DM, and kidney disease management, in this review, we analyze the renal effects of SGLT2, the benefits derived from its inhibition, and how this may result in the multiple CV and renal benefits evidenced in recent clinical trials.

Keywords: Cardiovascular outcomes; Chronic kidney disease; Heart failure; Renal protection; SGLT2 inhibitors; Type 2 diabetes mellitus.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Fig. 1
Fig. 1
Effects of SGLT2 inhibition on the kidney and direct and indirect renal benefits obtained through SGLT2 inhibition (see in the text from reference to reference 8)
See this image and copyright information in PMC

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