Abstract
Diabetic kidney disease is associated with a high risk of chronic renal failure. To slow down the progression of renal insufficiency in patients with diabetic kidney disease, renin- -angiotensin system inhibitors have been used and more recently, a significant renoprotective effect has also been demonstrated with inhibitors of the sodium-glucose cotransporter 2 (SGLT2) - gliflozins.
The renoprotective effect of SGLT2 inhibitors is predominantly hemodynamic and independent of their antidiabetic effect, SGLT2 inhibitors therefore might favorably affect the progression of renal insufficiency even in patients without DM. So far, dapagliflozin is the first drug from the group of SGLT2 in which this effect has been shown.
When administered in the DAPA-CKD study, there was a 39% reduction in the incidence of the primary composite endpoint (a permanent decrease in estimated glomerular filtration rate of 50%, terminal chronic renal failure or death from renal or cardiovascular causes) compared with placebo, a 39% reduction in patients with type 2 DM and even a 50% reduction in non-diabetic patients. Thus, SGLT2 inhibitors could become the standard of treatment even in non- -diabetic patients with chronic kidney disease.