钠-葡萄糖协同转运蛋白2抑制剂治疗糖尿病肾病的研究新进展

Abstract
Figure/Table
References (31)
Related Citation (15)

Download: PDF (433 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Diabetic nephropathy (DN) is a common and serious microvascular complication of diabetes mellitus, and it is the leading cause of end-stage renal disease (ESRD). Despite the use of various drugs such as renin-angiotensin system inhibitors, DN often continues to progress, and patients are at great risk of progressing to ESRD. Sodium-glucose cotransporter 2 inhibitors (SGLT-2i) are a novel class of target drugs that have been extensively investigated in type 2 diabetes mellitus (T2DM). The inhibitors block sodium and glucose reabsorption in the renal proximal tubule, leading to glycosuria for the treatment of hyperglycemia. Recent large scale clinical trials in T2DM patients have shown that SGLT-2i exhibit cardiorenal protective propertiesin in addition to its hypoglycemic effects. Especially in the patients complicated with DN, SGLT-2i are found to protect renal function and reduce urinary albumin excretion through various mechanisms. Therefore, the latest studies have discovered that SGLT-2i can significantly improve the prognosis of patients with DN. This article reviews the recent progress on SGLT-2i for renal protective effects and mechanisms in DN.

Key words： Sodium-glucose cotransporter 2 Sodium-glucose cotransporter 2 inhibitor Type 2 diabetes mellitus Diabetic nephropathy

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	REN Yanrong1
	2 YU Lei2▲

Cite this article:

REN Yanrong1,2 YU Lei2▲. New progress of sodium-glucose cotransporter 2 inhibitors in the treatment of diabetic nephropathy[J]. 中国医药导报, 2021, 18(14): 32-35.

URL:

https://www.yiyaodaobao.com.cn/EN/ OR https://www.yiyaodaobao.com.cn/EN/Y2021/V18/I14/32

[1] Liyanage T，Ninomiya T，Jha V，et al. Worldwide access to treatment for end-stage kidney disease：a systematic review [J]. Lancet，2015，385（9981）：1975-1982.
[2] DeFronzo RA，Davidson JA，Del Prato S. The role of the kidneys in glucose homeostasis：a new path towards normalizing glycaemia [J]. Diabetes Obes Metab，2012，14（1）：5-14.
[3] DeFronzo RA，Hompesch M，Kasichayanula S，et al. Characterization of renal glucose reabsorption in response to dapagliflozin in healthy subjects and subjects with type 2 diabetes [J]. Diabetes Care，2013，36（10）：3169-3176.
[4] Neuen BL，Young T，Heerspink HJL，et al. SGLT2 inhibitors for the prevention of kidney failure in patients with type 2 diabetes：a systematic review and meta-analysis [J]. Lancet Diabetes Endocrinol，2019，7（11）：845-854.
[5] Heerspink HJL，Stefansson BV，Chertow GM，et al. DAPA-CKD Investigators. Rationale and protocol of the Dapagliflozin And Prevention of Adverse outcomes in Chronic Kidney Disease（DAPA-CKD） randomized controlled trial [J]. Nephrol Dial Transplant，2020，35（2）：274-282.
[6] Dekkers CCJ，Gansevoort RT，Heerspink HJL． New Diabetes Therapies and Diabetic Kidney Disease Progression: the Role of SGLT-2 Inhibitors [J]. Curr Diab Rep，2018，18（5）：27.
[7] Scheen AJ. Pharmacodynamics，efficacy and safety of sodium-glucose co-transporter type 2（SGLT2）inhibitors for the treatment of type 2 diabetes mellitus[J]. Drugs，2015， 75（1）：33-59.
[8] Cherney DZI，Cooper ME， Tikkanen I，et al. Pooled analysis of Phase Ⅲ trials indicate contrasting influences of renal function on blood pressure，body weight，and HbA1c reductions with empagliflozin [J]. Kidney Int，2018，93（1）：231-244.
[9] DeFronzo RA，Lewin A，Patel S，et al． Combination of empagliflozin and linagliptin as second-line therapy in subjects with type 2 diabetes inadequately controlled on metformin [J]. Diabetes Care，2015，38（3）：384-393.
[10] van Bommel EJ，Muskiet MH，Tonneijck L，et al. SGLT2 Inhibition in the Diabetic Kidney-From Mechanisms to Clinical Outcome[J]. Clin J Am Soc Nephrol，2017，12（4）：700-710.
[11] Pareek M，Schauer PR，Kaplan LM，et al. Metabolic Surgery: Weight Loss，Diabetes，and Beyond[J]. J Am Coll Cardiol，2018，71（6）：670-687.
[12] Lee PC，Ganguly S，Goh SY. Weight loss associated with sodium-glucose cotransporter-2 inhibition: a review of evidence and underlying mechanisms [J]. Obes Rev，2018， 19（12）：1630-1641.
[13] Bolinder J，Ljunggren ?魻，Kullberg J，et al. Effects of dapagliflozin on body weight，total fat mass，and regional adipose tissue distribution in patients with type 2 diabetes mellitus with inadequate glycemic control on metformin [J]. J Clin Endocrinol Metab，2012，97（3）：1020-1031.
[14] Ferrannini E，Baldi S，Frascerra S，et al. Shift to Fatty Substrate Utilization in Response to Sodium-Glucose Cotransporter 2 Inhibition in Subjects Without Diabetes and Patients With Type 2 Diabetes [J]. Diabetes，2016， 65（5）：1190-1195.
[15] Mazidi M，Rezaie P，Gao HK，et al. Effect of Sodium-Glucose Cotransport-2 Inhibitors on Blood Pressure in People With Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of 43 Randomized Control Trials With 22 528 Patients[J]. J Am Heart Assoc，2017，6（6）：e004007.
[16] Baker WL，Buckley LF，Kelly MS，et al. Effects of Sodium-Glucose Cotransporter 2 Inhibitors on 24-Hour Ambulatory Blood Pressure：A Systematic Review and Meta-Analysis [J]. J Am Heart Assoc，2017，6（5）：e005686.
[17] Lovshin JA，Gilbert RE. Are SGLT2 inhibitors reasonable antihypertensive drugs and renoprotective? [J]. Curr Hypertens Rep，2015，17（6）：551.
[18] Zhao Y，Xu L，Tian D，et al. Effects of sodium-glucose co-transporter 2（SGLT2） inhibitors on serum uric acid level：A meta analysis of randomized controlled trials [J]. Diabetes Obes Metab，2018，20（2）：458-462.
[19] Bailey CJ. Uric acid and the cardio-renal effects of SGLT2 inhibitors [J]. Diabetes Obes Metab，2019，21（6）：1291-1298.
[20] Vallon V，Thomson SC. The tubular hypothesis of nephron filtration and diabetic kidney disease [J]. Nat Rev Nephrol，2020，16（6）：317-336.
[21] Lytvyn Y，Bjornstad P，Udell JA，et al. Sodium Glucose Cotransporter-2 Inhibition in Heart Failure：Potential Mechanisms，Clinical Applications，and Summary of Clinical Trials [J]. Circulation，2017，136（17）；1643-1658.
[22] Giacco F，Brownlee M. Oxidative stress and diabetic complications [J]. Circ Res，2010，107（9）：1058-1070.
[23] Packer M. Role of Impaired Nutrient and Oxygen Deprivation Signaling and Deficient Autophagic Flux in Diabetic CKD Development：Implications for Understanding the Effects of Sodium-Glucose Cotransporter 2-Inhibitors [J]. J Am Soc Nephrol，2020，31（5）：907-919.
[24] Packer M. Role of Deranged Energy Deprivation Signaling in the Pathogenesis of Cardiac and Renal Disease in States of Perceived Nutrient Overabundance [J]. Circulation，2020，141（25）：2095-2105.
[25] Benjamin T，Schumacher C. Characterization of Risk Factors for Genitourinary Infections with Sodium-Glucose Cotransporter-2 Inhibitors [J]. Pharmacotherapy，2020， 40（10）：1002-1011.
[26] Engelhardt K，Ferguson M，Rosselli JL. Prevention and Management of Genital Mycotic Infections in the Setting of Sodium-Glucose Cotransporter 2 Inhibitors [J]. Ann Pha-rmacother，2020：1060028020951928.
[27] Fralick M，Schneeweiss S，Patorno E. Risk of Diabetic Ketoacidosis after Initiation of an SGLT2 Inhibitor[J]. N Engl J Med，2017，376（23）：2300-2302.
[28] Huang CY，Lee JK. Sodium-glucose co-transporter-2 inhibitors and major adverse limb events：A trial-level meta-analysis including 51713 individuals[J]. Diabetes Obes Metab，2020，22（12）：2348-2355.
[29] Jackson K，Moseley KF. Diabetes and Bone Fragility：SGLT2 Inhibitor Use in the Context of Renal and Cardiovascular Benefits[J]. Curr Osteoporos Rep，2020，18（5）：439-448.
[30] Iskander C，Cherney DZ，Clemens KK，et al. Use of sodium-glucose cotransporter-2 inhibitors and risk of acute kidney injury in older adults with diabetes：a population-based cohort study [J]. CMAJ，2020，192（14）：E351-E360.
[31] Shi FH，Li H，Yue J，et al. Clinical Adverse Events of High-Dose vs Low-Dose Sodium-Glucose Cotransporter 2 Inhibitors in Type 2 Diabetes：A Meta-Analysis of 51 Randomized Clinical Trials [J]. J Clin Endocrinol Metab，2020，105（11）：dgaa586.