Exploring the Cardiorenal Benefits of SGLT2i: A Comprehensive Review
The history of sodium-glucose cotransporter 2 inhibitors (SGLT2i) is so long and started in 1835 when Petersen extracted a compound called phlorizin from apple tree bark. About fifty years later, von Mering discovered its glucosuric properties. In the 1980s, it was discovered that the glucosuria res...
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MDPI AG
2024-10-01
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| author | Angelica Cersosimo Andrea Drera Marianna Adamo Marco Metra Enrico Vizzardi |
| author_facet | Angelica Cersosimo Andrea Drera Marianna Adamo Marco Metra Enrico Vizzardi |
| author_sort | Angelica Cersosimo |
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| description | The history of sodium-glucose cotransporter 2 inhibitors (SGLT2i) is so long and started in 1835 when Petersen extracted a compound called phlorizin from apple tree bark. About fifty years later, von Mering discovered its glucosuric properties. In the 1980s, it was discovered that the glucosuria resulted from inhibition by phlorizin of glucose reabsorption by the renal tubules, which lowered blood glucose levels in diabetic rats. Nowadays, beyond their glucose-lowering effects, growing evidence suggests significant cardiorenal benefits associated with SGLT2i therapy. Indeed, several clinical trials, including landmark studies such as EMPA-REG OUTCOME, CANVAS Program, and DECLARE-TIMI 58, have demonstrated robust reductions in cardiovascular events, particularly heart failure hospitalizations and cardiovascular mortality, among patients treated with SGLT2i. However, subsequent trials showed that SGLT2i benefits extend beyond the diabetic population, encompassing individuals with and without diabetes. Additionally, SGLT2i exhibit nephroprotective effects, manifesting as a slowing of the progression of chronic kidney disease and a reduction in the risk of end-stage kidney disease. The mechanisms underlying the cardiorenal benefits of SGLT2i are multifactorial and include improvements in glycemic control, reduction in arterial stiffness, modulation of inflammation and oxidative stress, reduction of intraglomerular pression and promotion of natriuresis and diuresis through inhibition of SGLT2 in the luminal brush border of the first segments of the proximal kidney tubule. This narrative review aims to explore the cardiorenal outcomes of SGLT2i, encompassing their mechanisms of action, clinical evidence, safety profile, and implications for clinical practice. |
| format | Article |
| id | doaj-art-eeacb85681b849f3a720bcf34efc6cdf |
| institution | Kabale University |
| issn | 2673-8236 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | MDPI AG |
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| series | Kidney and Dialysis |
| spelling | doaj-art-eeacb85681b849f3a720bcf34efc6cdf2024-12-27T14:34:41ZengMDPI AGKidney and Dialysis2673-82362024-10-014418420210.3390/kidneydial4040016Exploring the Cardiorenal Benefits of SGLT2i: A Comprehensive ReviewAngelica Cersosimo0Andrea Drera1Marianna Adamo2Marco Metra3Enrico Vizzardi4Department of Medical and Surgical Specialties, Institute of Cardiology, University of Brescia, 25123 Brescia, ItalyDepartment of Medical and Surgical Specialties, Institute of Cardiology, University of Brescia, 25123 Brescia, ItalyDepartment of Medical and Surgical Specialties, Institute of Cardiology, University of Brescia, 25123 Brescia, ItalyDepartment of Medical and Surgical Specialties, Institute of Cardiology, University of Brescia, 25123 Brescia, ItalyDepartment of Medical and Surgical Specialties, Institute of Cardiology, University of Brescia, 25123 Brescia, ItalyThe history of sodium-glucose cotransporter 2 inhibitors (SGLT2i) is so long and started in 1835 when Petersen extracted a compound called phlorizin from apple tree bark. About fifty years later, von Mering discovered its glucosuric properties. In the 1980s, it was discovered that the glucosuria resulted from inhibition by phlorizin of glucose reabsorption by the renal tubules, which lowered blood glucose levels in diabetic rats. Nowadays, beyond their glucose-lowering effects, growing evidence suggests significant cardiorenal benefits associated with SGLT2i therapy. Indeed, several clinical trials, including landmark studies such as EMPA-REG OUTCOME, CANVAS Program, and DECLARE-TIMI 58, have demonstrated robust reductions in cardiovascular events, particularly heart failure hospitalizations and cardiovascular mortality, among patients treated with SGLT2i. However, subsequent trials showed that SGLT2i benefits extend beyond the diabetic population, encompassing individuals with and without diabetes. Additionally, SGLT2i exhibit nephroprotective effects, manifesting as a slowing of the progression of chronic kidney disease and a reduction in the risk of end-stage kidney disease. The mechanisms underlying the cardiorenal benefits of SGLT2i are multifactorial and include improvements in glycemic control, reduction in arterial stiffness, modulation of inflammation and oxidative stress, reduction of intraglomerular pression and promotion of natriuresis and diuresis through inhibition of SGLT2 in the luminal brush border of the first segments of the proximal kidney tubule. This narrative review aims to explore the cardiorenal outcomes of SGLT2i, encompassing their mechanisms of action, clinical evidence, safety profile, and implications for clinical practice.https://www.mdpi.com/2673-8236/4/4/16SGLT2 inhibitorsdiabetes mellituschronic kidney diseasecardiovascular diseaseheart failure |
| spellingShingle | Angelica Cersosimo Andrea Drera Marianna Adamo Marco Metra Enrico Vizzardi Exploring the Cardiorenal Benefits of SGLT2i: A Comprehensive Review Kidney and Dialysis SGLT2 inhibitors diabetes mellitus chronic kidney disease cardiovascular disease heart failure |
| title | Exploring the Cardiorenal Benefits of SGLT2i: A Comprehensive Review |
| title_full | Exploring the Cardiorenal Benefits of SGLT2i: A Comprehensive Review |
| title_fullStr | Exploring the Cardiorenal Benefits of SGLT2i: A Comprehensive Review |
| title_full_unstemmed | Exploring the Cardiorenal Benefits of SGLT2i: A Comprehensive Review |
| title_short | Exploring the Cardiorenal Benefits of SGLT2i: A Comprehensive Review |
| title_sort | exploring the cardiorenal benefits of sglt2i a comprehensive review |
| topic | SGLT2 inhibitors diabetes mellitus chronic kidney disease cardiovascular disease heart failure |
| url | https://www.mdpi.com/2673-8236/4/4/16 |
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