Sodium glucose co-transporter 2 inhibitors (SGLT2i) for pediatric kidney disease: the future is near
The sodium glucose co-transporter 2 (SGLT2) functions in the proximal tubule to reabsorb the bulk of filtered glucose. SGLT2 inhibitors have been developed to promote renal glucose excretion to improve glycemic control in diabetes. Regulatory guidance mandated adequately powered studies to detect in...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2025.1521425/full |
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| author | Gilda M. Portalatin Irene Hong-McAtee Irene Hong-McAtee Anna M. Burgner Edward R. Gould Tracy E. Hunley Tracy E. Hunley |
| author_facet | Gilda M. Portalatin Irene Hong-McAtee Irene Hong-McAtee Anna M. Burgner Edward R. Gould Tracy E. Hunley Tracy E. Hunley |
| author_sort | Gilda M. Portalatin |
| collection | DOAJ |
| description | The sodium glucose co-transporter 2 (SGLT2) functions in the proximal tubule to reabsorb the bulk of filtered glucose. SGLT2 inhibitors have been developed to promote renal glucose excretion to improve glycemic control in diabetes. Regulatory guidance mandated adequately powered studies to detect increased cardiovascular risk from emerging hypoglycemic medications. This led to recognition of remarkable improvement in cardiovascular and kidney outcomes with SGLT2 inhibition. Moreover, cardiovascular and kidney benefits extend beyond patients with diabetes. The dramatic kidney benefits of SGLT2 inhibitors documented in CKD in adult patients underscores the need for pediatric nephrologists to familiarize themselves with SGLT2 inhibitor therapies. This review explores the currently available body of knowledge regarding the kidney protective effects of SGLT2 inhibitors in adults and mechanisms thought to contribute to improved kidney outcomes. The limited data for SGLT2i treatment in pediatric kidney disease are reviewed and highlight the need for randomized controlled trials of this drug class in pediatric kidney patients as has been done for pediatric diabetes. Dosing patterns for SGLT2 inhibitors from other pediatric settings are reviewed as well as guidance for initiating SGLT2 inhibition in young adults remaining in pediatric nephrology care. |
| format | Article |
| id | doaj-art-2589078c18cd44989ccf55974146d762 |
| institution | Kabale University |
| issn | 2296-2360 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj-art-2589078c18cd44989ccf55974146d7622025-01-30T06:22:31ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602025-01-011310.3389/fped.2025.15214251521425Sodium glucose co-transporter 2 inhibitors (SGLT2i) for pediatric kidney disease: the future is nearGilda M. Portalatin0Irene Hong-McAtee1Irene Hong-McAtee2Anna M. Burgner3Edward R. Gould4Tracy E. Hunley5Tracy E. Hunley6Division of Nephrology, Vanderbilt University Medical Center, Nashville, TN, United StatesDivision of Pediatric Endocrinology, Vanderbilt University Medical Center, Nashville, TN, United StatesMonroe Carell Jr. Children’s Hospital at Vanderbilt, Vanderbilt University Medical Center, Nashville, TN, United StatesDivision of Nephrology, Vanderbilt University Medical Center, Nashville, TN, United StatesDivision of Nephrology, Vanderbilt University Medical Center, Nashville, TN, United StatesMonroe Carell Jr. Children’s Hospital at Vanderbilt, Vanderbilt University Medical Center, Nashville, TN, United StatesDivision of Pediatric Nephrology, Vanderbilt University Medical Center, Nashville, TN, United StatesThe sodium glucose co-transporter 2 (SGLT2) functions in the proximal tubule to reabsorb the bulk of filtered glucose. SGLT2 inhibitors have been developed to promote renal glucose excretion to improve glycemic control in diabetes. Regulatory guidance mandated adequately powered studies to detect increased cardiovascular risk from emerging hypoglycemic medications. This led to recognition of remarkable improvement in cardiovascular and kidney outcomes with SGLT2 inhibition. Moreover, cardiovascular and kidney benefits extend beyond patients with diabetes. The dramatic kidney benefits of SGLT2 inhibitors documented in CKD in adult patients underscores the need for pediatric nephrologists to familiarize themselves with SGLT2 inhibitor therapies. This review explores the currently available body of knowledge regarding the kidney protective effects of SGLT2 inhibitors in adults and mechanisms thought to contribute to improved kidney outcomes. The limited data for SGLT2i treatment in pediatric kidney disease are reviewed and highlight the need for randomized controlled trials of this drug class in pediatric kidney patients as has been done for pediatric diabetes. Dosing patterns for SGLT2 inhibitors from other pediatric settings are reviewed as well as guidance for initiating SGLT2 inhibition in young adults remaining in pediatric nephrology care.https://www.frontiersin.org/articles/10.3389/fped.2025.1521425/fullempagliflozindapagliflozincanagliflozinpediatric chronic kidney diseaseSGLT2 inhibitorschronic kidney disease |
| spellingShingle | Gilda M. Portalatin Irene Hong-McAtee Irene Hong-McAtee Anna M. Burgner Edward R. Gould Tracy E. Hunley Tracy E. Hunley Sodium glucose co-transporter 2 inhibitors (SGLT2i) for pediatric kidney disease: the future is near Frontiers in Pediatrics empagliflozin dapagliflozin canagliflozin pediatric chronic kidney disease SGLT2 inhibitors chronic kidney disease |
| title | Sodium glucose co-transporter 2 inhibitors (SGLT2i) for pediatric kidney disease: the future is near |
| title_full | Sodium glucose co-transporter 2 inhibitors (SGLT2i) for pediatric kidney disease: the future is near |
| title_fullStr | Sodium glucose co-transporter 2 inhibitors (SGLT2i) for pediatric kidney disease: the future is near |
| title_full_unstemmed | Sodium glucose co-transporter 2 inhibitors (SGLT2i) for pediatric kidney disease: the future is near |
| title_short | Sodium glucose co-transporter 2 inhibitors (SGLT2i) for pediatric kidney disease: the future is near |
| title_sort | sodium glucose co transporter 2 inhibitors sglt2i for pediatric kidney disease the future is near |
| topic | empagliflozin dapagliflozin canagliflozin pediatric chronic kidney disease SGLT2 inhibitors chronic kidney disease |
| url | https://www.frontiersin.org/articles/10.3389/fped.2025.1521425/full |
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