SGLT-2 inhibitors in diabetes: a focus on renoprotection
Rev. Assoc. Med. Bras. (1992)
;
66(supl.1): s17-s24, 2020. tab, graf
Artigo
em Inglês
| LILACS
| ID: biblio-1057108
ABSTRACT
SUMMARY Type 2 diabetes mellitus is an important public health problem, with a significant impact on cardiovascular morbidity and mortality and an important risk factor for chronic kidney disease. Various hypoglycemic therapies have proved to be beneficial to clinical outcomes, while others have failed to provide an improvement in cardiovascular and renal failure, only reducing blood glucose levels. Recently, sodium-glucose cotransporter-2 (SGLT2) inhibitors, represented by the empagliflozin, dapagliflozin, and canagliflozin, have been showing satisfactory and strong results in several clinical trials, especially regarding the reduction of cardiovascular mortality, reduction of hospitalization due to heart failure, reduction of albuminuria, and long-term maintenance of the glomerular filtration rate. The benefit from SGLT2 inhibitors stems from its main mechanism of action, which occurs in the proximal tubule of the nephron, causing glycosuria, and a consequent increase in natriuresis. This leads to increased sodium intake by the juxtaglomerular apparatus, activating the tubule glomerular-feedback and, finally, reducing intraglomerular hypertension, a frequent physiopathological condition in kidney disease caused by diabetes. In addition, this class of medication presents an appropriate safety profile, and its most frequently reported complication is an increase in the incidence of genital infections. Thus, these hypoglycemic agents gained space in practical recommendations for the management of type 2 diabetes mellitus and should be part of the initial therapeutic approach to provide, in addition to glycemic control, cardiovascular outcomes, and the renoprotection in the long term.
Texto completo:
DisponíveL
Índice:
LILACS (Américas)
Assunto principal:
Doenças Cardiovasculares
/
Diabetes Mellitus Tipo 2
/
Transportador 2 de Glucose-Sódio
/
Inibidores do Transportador 2 de Sódio-Glicose
/
Hipoglicemiantes
/
Nefropatias
Tipo de estudo:
Estudo de etiologia
/
Guia de Prática Clínica
/
Fatores de risco
Limite:
Humanos
Idioma:
Inglês
Revista:
Rev. Assoc. Med. Bras. (1992)
Ano de publicação:
2020
Tipo de documento:
Artigo
País de afiliação:
Brasil
Instituição/País de afiliação:
Hospital do Rim/BR
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