SGLT-2 Inhibition: A Potential New Treatment for Diabetic Kidney Disease?

Abstract:

:Diabetic nephropathy is the leading cause of kidney failure. Treatments with drugs that block the renin-angiotensin system have proven beneficial in slowing kidney disease progression among those with diabetes; their benefit is limited and they do not stop disease progression. Despite multiple clinical trials of various interventions including dual blockade of the renin-angiotensin system over the past 15 years, no new therapies have emerged to slow kidney disease progression in diabetes. SGLT-2 inhibitors are a new class of antiglycemic drugs that have been shown to lower blood glucose by inhibition of the sodium-glucose transporter 2 in the proximal tubule of the kidney. Several of these inhibitors have been marketed for treatment of hyperglycemia in patients with type 2 diabetes mellitus. In a recent double-blind randomized and placebo-controlled trial of cardiovascular outcomes, an SGLT-2 inhibitor-based intervention using empagliflozin was shown to be superior to placebo-based regimen for reducing the risk of major cardiovascular events among people with type 2 diabetes and established cardiovascular disease. In a pre-specified secondary analysis of renal outcomes from this trial, Wanner et al. [N Engl J Med 2016;375:323-334] recently reported that empagliflozin administration was also associated with significant reductions in the progression of kidney disease including the rate of decline in estimated glomerular filtration rate (eGFR), progression of albuminuria and initiation of renal replacement therapy. While the results of this trial are striking and impressive, the majority of those enrolled in the trial did not have evidence of diabetic kidney disease as assessed by eGFR or albuminuria. Thus, whether or not they represent a breakthrough in the treatment of diabetic nephropathy remains to be determined. Several ongoing clinical trials are in the planning stages to evaluate SGLT-2 inhibition in a population of patients with overt kidney disease. These trials will help to substantiate, or not, the potential for this class of drugs to be added to the armamentarium of therapeutic strategies to prevent progression of kidney disease in diabetes.

journal_name

Nephron

journal_title

Nephron

authors

Toto RD

doi

10.1159/000450895

subject

Has Abstract

pub_date

2017-01-01 00:00:00

pages

64-67

issue

1

eissn

1660-8151

issn

2235-3186

pii

000450895

journal_volume

137

pub_type

杂志文章,评审

相关文献

NEPHRON文献大全
  • Increased clearance rate of prednisone in the isolated perfused liver of uremic rats.

    abstract::The effect of uremia upon the hepatic clearance rate of prednisone was studied in isolated perfused livers of normal and uremic female rats. The perfusion rate was kept at a constant flow rate of 25 ml/min. In order to induce uremia, one group of rats was 5/6 nephrectomized 3 weeks prior to the perfusions. The concent...

    journal_title:Nephron

    pub_type: 杂志文章

    doi:10.1159/000184072

    authors: Egfjord W,Langhoff E,Daugaard H,Olgaard K

    更新日期:1987-01-01 00:00:00

  • Acute renal failure associated with Yersinia pseudotuberculosis infection.

    abstract::Since 1987, we have experienced 11 children with acute renal failure (ARF) associated with Yersinia pseudotuberculosis (YP) infection. The illness began with the sudden onset of high fever, skin rash and gastrointestinal symptoms. Later in the course, periungual desquamation developed, mimicking Kawasaki disease. Elev...

    journal_title:Nephron

    pub_type: 杂志文章

    doi:10.1159/000188611

    authors: Cheong HI,Choi EH,Ha IS,Lee HJ,Choi Y

    更新日期:1995-01-01 00:00:00

  • Glycosaminoglycans and oxalocalcic urolithiasis.

    abstract::A very simple analytical procedure with dimethylmethylene blue as photometric reagent was applied for the evaluation of glycosaminoglycan (GAG) urinary excretions and concentrations in both sexes, calcium oxalate stone formers, and a control group. The GAG concentrations varied significantly in stone formers (males an...

    journal_title:Nephron

    pub_type: 杂志文章

    doi:10.1159/000188306

    authors: Grases F,Llompart I,Conte A,Coll R,March JG

    更新日期:1994-01-01 00:00:00

  • Unusual complication in a patient with renal transplantation: cerebral cysticercosis.

    abstract::A patient with cadaveric renal transplantation was diagnosed by brain-computed tomography and ELISA as having neurocysticercosis in the CSF. Complete cure was achieved after praziquantel therapy. Function of the allograft was not affected. ...

    journal_title:Nephron

    pub_type: 杂志文章

    doi:10.1159/000184074

    authors: Gordillo-Paniagua G,Muñoz-Arizpe R,Ponsa-Molina R

    更新日期:1987-01-01 00:00:00

  • Control of aldosterone secretion.

    abstract::This paper reviews the control of aldosterone secretion, including the role played by hepatic metabolic clearance, ACTH, and the renin-angiotensin system, and the interrelationships of aldosterone secretion with sodium and potassium metabolism. The physiological modulations of aldosterone secretion by the upright post...

    journal_title:Nephron

    pub_type: 杂志文章

    doi:10.1159/000181613

    authors: Chan JC

    更新日期:1979-01-01 00:00:00

  • Exercise capacity in hemodialysis, CAPD, and renal transplant patients.

    abstract::Eighteen hemodialysis, 12 chronic ambulatory peritoneal dialysis (CAPD), and 20 renal transplant patients performed maximal treadmill exercise tests. Heart rates and blood pressures were determined every minute and maximal oxygen consumption was measured directly. Exercise capacity as measured by VO2 max is low in dia...

    journal_title:Nephron

    pub_type: 杂志文章

    doi:10.1159/000183632

    authors: Painter P,Messer-Rehak D,Hanson P,Zimmerman SW,Glass NR

    更新日期:1986-01-01 00:00:00

  • Relationship of sympathetic nervous system tone and blood pressure.

    abstract::Plasma concentrations of norepinephrine (NE) appear to reflect sympathetic nervous system (SNS) tone. Plasma NE increases substantially when the SNS is stressed by acute postural change or physical exercise. Standing up from the recumbent position elevates NE by about 90% in healthy normotensive and hypertensive subje...

    journal_title:Nephron

    pub_type: 杂志文章

    doi:10.1159/000181614

    authors: Lake CR

    更新日期:1979-01-01 00:00:00

  • Penicillamine nephropathy.

    abstract::8 patients who developed proteinuria whilst receiving penicillamine for rheumatoid arthritis have been studied. Light microscopy of renal biopsy specimens showed evidence of an extramembranous nephropathy in 6 cases, with epimembranous spikes infrequently described previously in association with penicillamine. ...

    journal_title:Nephron

    pub_type: 杂志文章

    doi:10.1159/000181984

    authors: Ross JH,McGinty F,Brewer DG

    更新日期:1980-01-01 00:00:00

  • Chromoblastomycosis in a renal transplant patient.

    abstract::Chromoblastomycosis is a rare, deep mycosis seen mostly in tropical and subtropical regions. We have encountered a kidney transplant recipient with this subcutaneous mycosis developing as an asymptomatic mass in the right forearm. The lesion recurred after an initial local excision, but it is now apparently cured 10 m...

    journal_title:Nephron

    pub_type: 杂志文章

    doi:10.1159/000183468

    authors: Morales LA,González ZA,Santiago-Delpín EA

    更新日期:1985-01-01 00:00:00

  • Hemolytic uremic syndrome as a presenting form of HIV infection.

    abstract::Human immunodeficiency virus (HIV) infection has been associated with several renal disorders. Thrombotic thrombocytopenic purpura/hemolytic uremic syndrome (TTP/HUS) were also described in several patients with overt AIDS. We describe a patient who presented with HUS and only subsequent investigation to find the caus...

    journal_title:Nephron

    pub_type: 杂志文章,评审

    doi:10.1159/000188916

    authors: Badesha PS,Saklayen MG

    更新日期:1996-01-01 00:00:00

  • Dialysis-induced eosinophilia.

    abstract::Blood eosinophils were counted by the counting-chamber method in 21 regular hemodialysis patients. Before dialysis, eosinophil counts were within the normal range in all patients (mean 98 cells/mm3, range 6-350). After the first 15 min of hemodialysis, with not reused coils or hollow-fiber dialysers, a significant dro...

    journal_title:Nephron

    pub_type: 杂志文章

    doi:10.1159/000182805

    authors: Bodner G,Peer G,Zakuth V,Spirer ZH,Aviram A

    更新日期:1982-01-01 00:00:00

  • Proliferative responses of mesangial cells to growth factors during compensatory versus dietary hypertrophy.

    abstract::While the bulk of renal hypertrophy induced by contralateral nephrectomy or a high-protein diet consists of tubular cell growth, there is some evidence suggesting that mesangial cells play a role in this phenomenon. Previous data suggest that this role of mesangial cells is associated with their proliferation. We, the...

    journal_title:Nephron

    pub_type: 杂志文章

    doi:10.1159/000045668

    authors: Weissgarten J,Modai D,Berman S,Cohn M,Galperin E,Averbukh Z

    更新日期:2000-07-01 00:00:00

  • Impaired renal hemodynamic but conserved natriuretic response to dopamine in patients with renal disease.

    abstract::Renal hemodynamics and sodium excretion were determined before and during infusion of dopamine in doses ranging from 0.25 to 8 micrograms/kg/min in healthy volunteers (n = 15) and in patients with renal disease and moderately impaired renal function (n = 21, baseline glomerular filtration rate 34-85 ml/min). While in ...

    journal_title:Nephron

    pub_type: 杂志文章

    doi:10.1159/000185674

    authors: Smit AJ,Meijer S,Wesseling H,Reitsma WD,Donker AJ

    更新日期:1989-01-01 00:00:00

  • Chemical analysis of water of the Anticolana Valley: isolation of humic compounds.

    abstract::The purpose of this study was to identify and characterize humic compounds in Anticolana Valley (Fiuggi) water. The capacity of this class of compounds to mobilize metals from solid phases could have an important role in calculi solubilization. Humic compounds were isolated, purified and characterised by FTIR, 1H-NMR ...

    journal_title:Nephron

    pub_type: 杂志文章

    doi:10.1159/000046304

    authors: Calace N,D'Ascenzo G,De Angelis Curtis S,Delfini M,Fraioli A,Petronio BM

    更新日期:1999-01-01 00:00:00

  • Intraperitoneal secretion of interleukin-6 during continuous ambulatory peritoneal dialysis.

    abstract::Interleukin-6 (IL-6) was determined in serum and peritoneal dialysis effluent (PDE) of patients on chronic ambulatory peritoneal dialysis (CAPD) by a biological assay measuring the proliferation of the IL-6-dependent 7TD1 cell line. Six patients free of peritonitis displayed low but significant levels of IL-6 (mean +/...

    journal_title:Nephron

    pub_type: 杂志文章

    doi:10.1159/000186154

    authors: Goldman M,Vandenabeele P,Moulart J,Amraoui Z,Abramowicz D,Nortier J,Vanherweghem JL,Fiers W

    更新日期:1990-01-01 00:00:00

  • Effects on serum parathyroid hormone of intravenous treatment with alphacalcidol in patients on chronic hemodialysis.

    abstract::Secondary hyperparathyroidism is common in chronic renal failure and is due to inadequate synthesis of calcitriol, the active metabolite of vitamin D. Intravenous administration of alphacalcidol, a synthetic analogue which is metabolized to calcitriol, was given during 12 weeks to 51 patients on chronic hemodialysis i...

    journal_title:Nephron

    pub_type: 杂志文章

    doi:10.1159/000186004

    authors: Ljunghall S,Althoff P,Fellström B,Marjanovic B,Nisell J,Weiss L,Wide L

    更新日期:1990-01-01 00:00:00

  • A case of isolated ACTH deficiency with hyporeninemic hypoaldosteronism.

    abstract::A case of isolated ACTH deficiency with hyporeninemic hypoaldosteronism, presenting severe hyponatremia, is described. A 57-year-old man complaining of nausea, vomiting and fatigability was admitted to our hospital because of hyponatremia (114 mEq/I). The low levels of serum cortisol and urinary 17-OHCS suggested gluc...

    journal_title:Nephron

    pub_type: 杂志文章

    doi:10.1159/000189056

    authors: Okada K,Takahashi S

    更新日期:1996-01-01 00:00:00

  • Prostaglandin and thromboxane formation in glomeruli from rats with reduced renal mass.

    abstract::In vitro formation of prostaglandins (PG) E2, F2 alpha, 6-keto-F1 alpha, and thromboxane B2 (TxB2) by glomeruli from rats with reduced renal mass (RRM) were evaluated by radioimmunoassay. Four weeks following ablation of renal mass, PGE2, PGF2 alpha, and TxB2 production by glomeruli from RRM rats was significantly gre...

    journal_title:Nephron

    pub_type: 杂志文章

    doi:10.1159/000183676

    authors: Stahl RA,Kudelka S,Paravicini M,Schollmeyer P

    更新日期:1986-01-01 00:00:00

  • Failure of verapamil to protect from ischaemic renal damage.

    abstract::To reassess the reported protective effects of verapamil in renal ischaemia, we perfused the left kidney of uninephrectomized female Wistar rats with verapamil (0.1 and 1.0 mg/kg) immediately prior to clamping the renal artery for 60 min. When compared to controls, both doses of verapamil failed to afford protection w...

    journal_title:Nephron

    pub_type: 杂志文章

    doi:10.1159/000186279

    authors: Bock HA,Brunner FP,Torhorst J,Thiel G

    更新日期:1991-01-01 00:00:00

  • Is Chronic Kidney Disease Progression Influenced by the Type of Renin-Angiotensin-System Blocker Used?

    abstract:INTRODUCTION:Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) reduce proteinuria and slow renal disease progression more effectively than other therapies in patients with chronic kidney disease (CKD). However, differences regarding efficacy and safety between these therapies rem...

    journal_title:Nephron

    pub_type: 杂志文章

    doi:10.1159/000500925

    authors: Silvariño R,Rios P,Baldovinos G,Chichet MA,Perg N,Sola L,Saona G,De Souza N,Lamadrid V,Gadola L

    更新日期:2019-01-01 00:00:00

  • Effect of 1 alpha-hydroxyvitamin D3 and dietary calcium and phosphate on the aortic mineral content in rabbits with mild azotemia.

    abstract::The effect of treatment with 1 alpha-hydroxycholecalciferol (1 alpha-OH-D3) and different diets on uremic arterial disease was studied. Three groups of rabbits with chronic renal failure (CRF) were kept on three diets with a low, medium or high content of calcium and phosphate. Half the rabbits in each group were trea...

    journal_title:Nephron

    pub_type: 杂志文章

    doi:10.1159/000183007

    authors: Tvedegaard E,Ladefoged O,Nielsen M,Kamstrup O

    更新日期:1983-01-01 00:00:00

  • Physiologic effects of prazosin HCl: consequences of diuretic combination therapy.

    abstract::The physiologic action of prazosin in man was studied in 23 patients including 10 treated with prazosin plus polythiazide. Responders to prazosin alone (blood pressure fell greater than 10 mm Hg) had a decrease in peripheral resistance (p less than 0.02) and no significant change in plasma volume, while nonresponders'...

    journal_title:Nephron

    pub_type: 杂志文章

    doi:10.1159/000182245

    authors: Blaufox MD,Ross L,Koshy K,Lee HB

    更新日期:1981-01-01 00:00:00

  • Glomerular-tubular balance for bicarbonate in man.

    abstract::We recently showed in dogs that there is a close relationship between bicarbonate reabsorption and glomerular filtration rate (GFR). The present studies were designed to confirm these findings in five normal men. Bicarbonate titrations were done after ingesting a low protein diet for one week and were repeated followi...

    journal_title:Nephron

    pub_type: 杂志文章

    doi:10.1159/000180453

    authors: Bennett CM,Falkinburg NR,Springberg PD

    更新日期:1975-01-01 00:00:00

  • Serum potassium concentration in acidemic states.

    abstract::It has been generally accepted that acidosis results in hyperkalemia because of shifts of potassium from the intracellular to the extracellular compartment. There is ample clinical and experimental evidence, however, to support the conclusion that uncomplicated organic acidemias do not produce hyperkalemia. In acidosi...

    journal_title:Nephron

    pub_type: 杂志文章,评审

    doi:10.1159/000182061

    authors: Perez GO,Oster JR,Vaamonde CA

    更新日期:1981-01-01 00:00:00

  • Effect of intravenous 1-alpha-hydroxyvitamin D3 on secondary hyperparathyroidism in chronic uremic patients on maintenance hemodialysis.

    abstract::The effect of intravenous 1 alpha(OH)D3 on circulating intact parathyroid hormone (PTH) and COOH-terminal immunoreactive PTH was examined in 21 patients on chronic hemodialysis. The patients were treated for 3 months with increasing doses of 1 alpha(OH)D3 under careful control of serum Ca2+. 1 alpha(OH)D3 was given in...

    journal_title:Nephron

    pub_type: 杂志文章

    doi:10.1159/000185744

    authors: Brandi L,Daugaard H,Tvedegaard E,Storm T,Olgaard K

    更新日期:1989-01-01 00:00:00

  • Angiotensin-converting enzyme inhibitors in the treatment of diabetic glomerulopathy.

    abstract::Continuous therapy with an angiotensin-converting enzyme (ACE) inhibitor has been shown to have a glomerular vasodepressor effect in the newly diabetic rat and to largely prevent subsequent development of severe sclerosing glomerular injury. Preliminary studies in humans with established diabetic glomerular injury rev...

    journal_title:Nephron

    pub_type: 杂志文章

    doi:10.1159/000186031

    authors: Myers BD,Meyer TW

    更新日期:1990-01-01 00:00:00

  • Establishing the relationship between complement activation and stimulation of phagocyte oxidative metabolism in hemodialyzed patients: a randomized prospective study.

    abstract::The present prospective study was conducted in order to establish the relationship between complement activation and stimulation of phagocyte oxidative metabolism observed in long-term hemodialysis (HD) patients during the early phase of dialysis with cellulosic membranes. Two groups of 10 randomized (HD) patients tre...

    journal_title:Nephron

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1159/000186565

    authors: Descamps-Latscha B,Goldfarb B,Nguyen AT,Landais P,London G,Haeffner-Cavaillon N,Jacquot C,Herbelin A,Kazatchkine M

    更新日期:1991-01-01 00:00:00

  • Involvement of interleukin-4 and soluble CD23 in hypersynthesis of immunoglobulins A and E in patients with IgA nephropathy.

    abstract::To determine the cytokines responsible for the increase in production of IgA in patients with IgA nephropathy (IgAN), the roles of interleukin-4 (IL-4) and soluble CD23 (sCD23) were examined. Peripheral blood mononuclear cells (PBMCs) and serum were obtained from 24 patients with IgAN and 14 patients with non-IgA prol...

    journal_title:Nephron

    pub_type: 杂志文章

    doi:10.1159/000188805

    authors: Yano N,Endoh M,Takemura F,Naka R,Kashem A,Nomoto Y,Sakai H

    更新日期:1996-01-01 00:00:00

  • Persistent post-transplant autonomous hyperparathyroidism despite 23 years of excellent renal allograft function.

    abstract::Hyperparathyroidism is a common problem for patients on renal replacement therapy programs. Many long-term dialysis patients require parathyroidectomy while on dialysis. Some patients, however, despite severe renal osteodystrophy, are transplanted, and in these a large proportion show a slow resolution of bony problem...

    journal_title:Nephron

    pub_type: 杂志文章

    doi:10.1159/000046051

    authors: Goldsmith D,Owen WJ

    更新日期:2001-09-01 00:00:00

  • Differences between blood flow as indicated by the hemodialysis blood roller pump and blood flow measured by an ultrasonic sensor.

    abstract:BACKGROUND/AIM:The ultrasonic transit time is currently the best method for measuring the blood flow rate in the extracorporeal hemodialysis circuit. The purpose of this study was to analyze the differences between blood flow as indicated by the hemodialysis blood roller pump (prescribed blood flow) and by an ultrasoni...

    journal_title:Nephron

    pub_type: 杂志文章

    doi:10.1159/000045647

    authors: Teruel JL,Fernández Lucas M,Marcén R,Rodríguez JR,López Sánchez J,Rivera M,Liaño F,Ortuño J

    更新日期:2000-06-01 00:00:00