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The mechanisms and clinical potential: sodium-glucose cotransporter 2 (SGLT-2) inhibitors treating diabetic kidney disease

WANG Yu-Jia, HAO Chuan-Ming^*

Division of Nephrology, Huashan Hospital, and Nephrology Research Institute, Fudan University, Shanghai 200040, China

Abstract

The employment of sodium-glucose cotransporter 2 (SGLT-2) inhibitors in the treatment of diabetes mellitus and diabetic kidney disease (DKD) becomes a hot topic in recent years. Compared with traditional glucose-lowering drugs, SGLT-2 inhibitors present distinctive advantages in renal and cardiovascular protection. The mechanisms for renal protection include attenuating glomerular hyperfiltration, lowering serum uric acid, alleviating tubular lesions and regulating intrarenal renin-angiotensin-aldosterone system (RAAS) dysfunction. In addition, the lowering blood pressure, blunting blood glucose fluctuation, increasing insulin sensitivity, optimizing energy metabolism and body fat distribution account for the cardiovascular protective effects of SGLT-2 inhibitors. However, their potential adverse reactions and safety concerns should be carefully addressed in clinical usage.

Key words: diabetic nephropathies; sodium-glucose cotransporter 2; glomerular hyperfiltration; uric acid; tubular lesions; blood pressure; energy metabolism; adverse reactions

Received: 2018-06-05　　Accepted: 2018-11-11

Corresponding author: 郝传明　　E-mail: Chuanminghao@fudan.edu.cn

DOI: 10.13294/j.aps.2018.0081

Citing This Article：

WANG Yu-Jia, HAO Chuan-Ming. The mechanisms and clinical potential: sodium-glucose cotransporter 2 (SGLT-2) inhibitors treating diabetic kidney disease. Acta Physiol Sin 2018; 70 (6): 663-669 (in Chinese with English abstract).