Inhibiteurs des SGLT2 chez les patients avec insuffisance rénale chronique : des essais contrôlés aux recommandations internationales et perspectives en pratique clinique. ; SGLT2 inhibitors in patients with chronic kidney disease : from clinical trials to guidelines and new prospects for clinical practice

peer reviewed ; Sodium-glucose cotransporter type 2 inhibitors (iSGLT2 or gliflozins) exert their antidiabetic action through a specific renal mechanism, by inhibiting tubular glucose reabsorption. These agents have proven their efficacy to reduce major cardiovascular events and hospitalisation for heart failure, but also the progression of chronic kidney disease (CKD), in patients with type 2 diabetes (T2DM) at high risk, independently of glucose control. While the glucose-lowering effect of iSGLT2 is decreasing with the decline of estimated glomerular filtration rate (eGFR), both cardiovascu... Mehr ...

Verfasser: Scheen, André
DELANAYE, Pierre
Dokumenttyp: journal article
Erscheinungsdatum: 2021
Verlag/Hrsg.: Université de Liège. Revue Médicale de Liège
Schlagwörter: Belgium / Diabetes Mellitus / Type 2/complications/drug therapy / Diabetic Nephropathies / Humans / Renal Insufficiency / Chronic/drug therapy / Sodium-Glucose Transporter 2 Inhibitors/therapeutic use / Cardiovascular disease / Gliflozin / Type 2 diabetes / Albuminuria / Human health sciences / Endocrinology / metabolism & nutrition / Urology & nephrology / Sciences de la santé humaine / Endocrinologie / métabolisme & nutrition / Urologie & néphrologie
Sprache: Französisch
Permalink: https://search.fid-benelux.de/Record/base-26585087
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : https://orbi.uliege.be/handle/2268/261928

peer reviewed ; Sodium-glucose cotransporter type 2 inhibitors (iSGLT2 or gliflozins) exert their antidiabetic action through a specific renal mechanism, by inhibiting tubular glucose reabsorption. These agents have proven their efficacy to reduce major cardiovascular events and hospitalisation for heart failure, but also the progression of chronic kidney disease (CKD), in patients with type 2 diabetes (T2DM) at high risk, independently of glucose control. While the glucose-lowering effect of iSGLT2 is decreasing with the decline of estimated glomerular filtration rate (eGFR), both cardiovascular and renal protections remain present until an eGFR as low as 30 ml/min/1,73 m². These effects were demonstrated in several meta-analyses and in two trials specifically dedicated to renal outcomes in patients with CKD and macroalbuminuria : CREDENCE with canagliflozin and Dapa-CKD with dapagliflozin. In addition, Dapa-CKD showed similar positive results whatever the presence or absence of T2DM. Safety profile of SGLT2is among patients with CKD is good and similar to that of patients with normal renal function. These favourable findings led to a privileged place of SGLT2i in recent international guidelines promoted by diabetologists, cardiologists and nephrologists. Current restrictive criteria for the prescription and reimbursement of SGLT2i in Belgium according to eGFR level (initiation only if eGFR superior to 60 and interruption if eGFR inferior to 45 ml/min/1.73 m²) should be enlarged very soon owing to convincing results of published controlled trials.