Effects of SGLT2 Inhibitors on Kidney and Cardiovascular Function.

Annual Review of Physiology
Volker Vallon, Subodh Verma

Abstract

SGLT2 inhibitors are antihyperglycemic drugs that protect kidneys and the heart of patients with or without type 2 diabetes and preserved or reduced kidney function from failing. The involved protective mechanisms include blood glucose-dependent and -independent mechanisms: SGLT2 inhibitors prevent both hyper- and hypoglycemia, with expectedly little net effect on HbA1C. Metabolic adaptations to induced urinary glucose loss include reduced fat mass and more ketone bodies as additional fuel. SGLT2 inhibitors lower glomerular capillary hypertension and hyperfiltration, thereby reducing the physical stress on the filtration barrier, albuminuria, and the oxygen demand for tubular reabsorption. This improves cortical oxygenation, which, together with lesser tubular gluco-toxicity, may preserve tubular function and glomerular filtration rate in the long term. SGLT2 inhibitors may mimic systemic hypoxia and stimulate erythropoiesis, which improves organ oxygen delivery. SGLT2 inhibitors are proximal tubule and osmotic diuretics that reduce volume retention and blood pressure and preserve heart function, potentially in part by overcoming the resistance to diuretics and atrial-natriuretic-peptide and inhibiting Na-H exchangers and sympa...Continue Reading

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Citations

Mar 27, 2021·Current Opinion in Nephrology and Hypertension·Caitlyn VlasschaertSamuel A Silver
Apr 20, 2021·Current Opinion in Lipidology·Julieta LazarteRobert A Hegele
May 25, 2021·Metabolism: Clinical and Experimental·Francesco PrattichizzoAntonio Ceriello
Jun 27, 2021·Acta Diabetologica·Angelo AvogaroGian Paolo Fadini
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Aug 31, 2021·Pharmacological Research : the Official Journal of the Italian Pharmacological Society·Peter KolkhofUlrich Kintscher
Oct 8, 2021·European Heart Journal·Naveed SattarSubodh Verma
Oct 5, 2021·Diabetes, Obesity & Metabolism·Preethika Ekanayake, Sunder Mudaliar

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