Renal haemodynamic and protective effects of renoactive drugs in type 2 diabetes: Interaction with SGLT2 inhibitors
Diabetic kidney disease remains the leading cause of end‐stage kidney disease and a major risk factor for cardiovascular disease. Large cardiovascular outcome trials and dedicated kidney trials have shown that sodium‐glucose cotransporter (SGLT)2 inhibitors reduce cardiovascular morbidity and mortal...
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Published in | Nephrology (Carlton, Vic.) Vol. 26; no. 5; pp. 377 - 390 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
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Melbourne
John Wiley & Sons Australia, Ltd
01.05.2021
Wiley Subscription Services, Inc |
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Abstract | Diabetic kidney disease remains the leading cause of end‐stage kidney disease and a major risk factor for cardiovascular disease. Large cardiovascular outcome trials and dedicated kidney trials have shown that sodium‐glucose cotransporter (SGLT)2 inhibitors reduce cardiovascular morbidity and mortality and attenuate hard renal outcomes in patients with type 2 diabetes (T2D). Underlying mechanisms explaining these renal benefits may be mediated by decreased glomerular hypertension, possibly by vasodilation of the post‐glomerular arteriole. People with T2D often receive several different drugs, some of which could also impact the renal vasculature, and could therefore modify both renal efficacy and safety of SGLT2 inhibition. The most commonly prescribed drugs that could interact with SGLT2 inhibitors on renal haemodynamic function include renin‐angiotensin system inhibitors, calcium channel blockers and diuretics. Herein, we review the effects of these drugs on renal haemodynamic function in people with T2D and focus on studies that measured glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) with gold‐standard techniques. In addition, we posit, based on these observations, potential interactions with SGLT2 inhibitors with an emphasis on efficacy and safety.
SUMMARY AT A GLANCE
This invited review describes the renal haemodynamic and protective effects of commonly prescribed drugs in people with type 2 diabetes and their interaction with SGLT2 inhibitors. |
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AbstractList | Diabetic kidney disease remains the leading cause of end-stage kidney disease and a major risk factor for cardiovascular disease. Large cardiovascular outcome trials and dedicated kidney trials have shown that sodium-glucose cotransporter (SGLT)2 inhibitors reduce cardiovascular morbidity and mortality and attenuate hard renal outcomes in patients with type 2 diabetes (T2D). Underlying mechanisms explaining these renal benefits may be mediated by decreased glomerular hypertension, possibly by vasodilation of the post-glomerular arteriole. People with T2D often receive several different drugs, some of which could also impact the renal vasculature, and could therefore modify both renal efficacy and safety of SGLT2 inhibition. The most commonly prescribed drugs that could interact with SGLT2 inhibitors on renal haemodynamic function include renin-angiotensin system inhibitors, calcium channel blockers and diuretics. Herein, we review the effects of these drugs on renal haemodynamic function in people with T2D and focus on studies that measured glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) with gold-standard techniques. In addition, we posit, based on these observations, potential interactions with SGLT2 inhibitors with an emphasis on efficacy and safety. Diabetic kidney disease remains the leading cause of end-stage kidney disease and a major risk factor for cardiovascular disease. Large cardiovascular outcome trials and dedicated kidney trials have shown that sodium-glucose cotransporter (SGLT)2 inhibitors reduce cardiovascular morbidity and mortality and attenuate hard renal outcomes in patients with type 2 diabetes (T2D). Underlying mechanisms explaining these renal benefits may be mediated by decreased glomerular hypertension, possibly by vasodilation of the post-glomerular arteriole. People with T2D often receive several different drugs, some of which could also impact the renal vasculature, and could therefore modify both renal efficacy and safety of SGLT2 inhibition. The most commonly prescribed drugs that could interact with SGLT2 inhibitors on renal haemodynamic function include renin-angiotensin system inhibitors, calcium channel blockers and diuretics. Herein, we review the effects of these drugs on renal haemodynamic function in people with T2D and focus on studies that measured glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) with gold-standard techniques. In addition, we posit, based on these observations, potential interactions with SGLT2 inhibitors with an emphasis on efficacy and safety.Diabetic kidney disease remains the leading cause of end-stage kidney disease and a major risk factor for cardiovascular disease. Large cardiovascular outcome trials and dedicated kidney trials have shown that sodium-glucose cotransporter (SGLT)2 inhibitors reduce cardiovascular morbidity and mortality and attenuate hard renal outcomes in patients with type 2 diabetes (T2D). Underlying mechanisms explaining these renal benefits may be mediated by decreased glomerular hypertension, possibly by vasodilation of the post-glomerular arteriole. People with T2D often receive several different drugs, some of which could also impact the renal vasculature, and could therefore modify both renal efficacy and safety of SGLT2 inhibition. The most commonly prescribed drugs that could interact with SGLT2 inhibitors on renal haemodynamic function include renin-angiotensin system inhibitors, calcium channel blockers and diuretics. Herein, we review the effects of these drugs on renal haemodynamic function in people with T2D and focus on studies that measured glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) with gold-standard techniques. In addition, we posit, based on these observations, potential interactions with SGLT2 inhibitors with an emphasis on efficacy and safety. Diabetic kidney disease remains the leading cause of end‐stage kidney disease and a major risk factor for cardiovascular disease. Large cardiovascular outcome trials and dedicated kidney trials have shown that sodium‐glucose cotransporter (SGLT)2 inhibitors reduce cardiovascular morbidity and mortality and attenuate hard renal outcomes in patients with type 2 diabetes (T2D). Underlying mechanisms explaining these renal benefits may be mediated by decreased glomerular hypertension, possibly by vasodilation of the post‐glomerular arteriole. People with T2D often receive several different drugs, some of which could also impact the renal vasculature, and could therefore modify both renal efficacy and safety of SGLT2 inhibition. The most commonly prescribed drugs that could interact with SGLT2 inhibitors on renal haemodynamic function include renin‐angiotensin system inhibitors, calcium channel blockers and diuretics. Herein, we review the effects of these drugs on renal haemodynamic function in people with T2D and focus on studies that measured glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) with gold‐standard techniques. In addition, we posit, based on these observations, potential interactions with SGLT2 inhibitors with an emphasis on efficacy and safety. This invited review describes the renal haemodynamic and protective effects of commonly prescribed drugs in people with type 2 diabetes and their interaction with SGLT2 inhibitors. Abstract Diabetic kidney disease remains the leading cause of end‐stage kidney disease and a major risk factor for cardiovascular disease. Large cardiovascular outcome trials and dedicated kidney trials have shown that sodium‐glucose cotransporter (SGLT)2 inhibitors reduce cardiovascular morbidity and mortality and attenuate hard renal outcomes in patients with type 2 diabetes (T2D). Underlying mechanisms explaining these renal benefits may be mediated by decreased glomerular hypertension, possibly by vasodilation of the post‐glomerular arteriole. People with T2D often receive several different drugs, some of which could also impact the renal vasculature, and could therefore modify both renal efficacy and safety of SGLT2 inhibition. The most commonly prescribed drugs that could interact with SGLT2 inhibitors on renal haemodynamic function include renin‐angiotensin system inhibitors, calcium channel blockers and diuretics. Herein, we review the effects of these drugs on renal haemodynamic function in people with T2D and focus on studies that measured glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) with gold‐standard techniques. In addition, we posit, based on these observations, potential interactions with SGLT2 inhibitors with an emphasis on efficacy and safety. SUMMARY AT A GLANCE This invited review describes the renal haemodynamic and protective effects of commonly prescribed drugs in people with type 2 diabetes and their interaction with SGLT2 inhibitors. Diabetic kidney disease remains the leading cause of end‐stage kidney disease and a major risk factor for cardiovascular disease. Large cardiovascular outcome trials and dedicated kidney trials have shown that sodium‐glucose cotransporter (SGLT)2 inhibitors reduce cardiovascular morbidity and mortality and attenuate hard renal outcomes in patients with type 2 diabetes (T2D). Underlying mechanisms explaining these renal benefits may be mediated by decreased glomerular hypertension, possibly by vasodilation of the post‐glomerular arteriole. People with T2D often receive several different drugs, some of which could also impact the renal vasculature, and could therefore modify both renal efficacy and safety of SGLT2 inhibition. The most commonly prescribed drugs that could interact with SGLT2 inhibitors on renal haemodynamic function include renin‐angiotensin system inhibitors, calcium channel blockers and diuretics. Herein, we review the effects of these drugs on renal haemodynamic function in people with T2D and focus on studies that measured glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) with gold‐standard techniques. In addition, we posit, based on these observations, potential interactions with SGLT2 inhibitors with an emphasis on efficacy and safety. SUMMARY AT A GLANCE This invited review describes the renal haemodynamic and protective effects of commonly prescribed drugs in people with type 2 diabetes and their interaction with SGLT2 inhibitors. |
Author | Cherney, David Z. I. Raalte, Daniël H. Joles, Jaap A. Kok, Megan D. Bjornstad, Petter Baar, Michaël J. B. Scholtes, Rosalie A. |
AuthorAffiliation | 5 Department of Nephrology and Hypertension University Medical Center Utrecht The Netherlands 2 Department of Pediatrics, Division of Endocrinology University of Colorado School of Medicine Aurora Colorado USA 3 Department of Medicine, Division of Nephrology University of Colorado School of Medicine Aurora Colorado USA 1 Amsterdam Diabetes Center, Department of Internal Medicine, Academic Medical Center VU University Medical Center Amsterdam The Netherlands 4 Department of Medicine and Department of Physiology, Division of Nephrology, University Health Network University of Toronto Toronto Ontario Canada 6 Department of Vascular Medicine, Academic Medical Center University of Amsterdam Amsterdam The Netherlands |
AuthorAffiliation_xml | – name: 5 Department of Nephrology and Hypertension University Medical Center Utrecht The Netherlands – name: 1 Amsterdam Diabetes Center, Department of Internal Medicine, Academic Medical Center VU University Medical Center Amsterdam The Netherlands – name: 6 Department of Vascular Medicine, Academic Medical Center University of Amsterdam Amsterdam The Netherlands – name: 4 Department of Medicine and Department of Physiology, Division of Nephrology, University Health Network University of Toronto Toronto Ontario Canada – name: 2 Department of Pediatrics, Division of Endocrinology University of Colorado School of Medicine Aurora Colorado USA – name: 3 Department of Medicine, Division of Nephrology University of Colorado School of Medicine Aurora Colorado USA |
Author_xml | – sequence: 1 givenname: Rosalie A. surname: Scholtes fullname: Scholtes, Rosalie A. email: r.scholtes@amsterdamumc.nl organization: VU University Medical Center – sequence: 2 givenname: Michaël J. B. surname: Baar fullname: Baar, Michaël J. B. organization: VU University Medical Center – sequence: 3 givenname: Megan D. surname: Kok fullname: Kok, Megan D. organization: VU University Medical Center – sequence: 4 givenname: Petter surname: Bjornstad fullname: Bjornstad, Petter organization: University of Colorado School of Medicine – sequence: 5 givenname: David Z. I. surname: Cherney fullname: Cherney, David Z. I. organization: University of Toronto – sequence: 6 givenname: Jaap A. surname: Joles fullname: Joles, Jaap A. organization: University Medical Center – sequence: 7 givenname: Daniël H. orcidid: 0000-0003-2894-6124 surname: Raalte fullname: Raalte, Daniël H. organization: University of Amsterdam |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/33283420$$D View this record in MEDLINE/PubMed |
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Keywords | diabetic kidney disease renal haemodynamic function RAS inhibitors calcium channel blockers diuretics SGLT2 inhibition type 2 diabetes humans |
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Snippet | Diabetic kidney disease remains the leading cause of end‐stage kidney disease and a major risk factor for cardiovascular disease. Large cardiovascular outcome... Diabetic kidney disease remains the leading cause of end-stage kidney disease and a major risk factor for cardiovascular disease. Large cardiovascular outcome... Abstract Diabetic kidney disease remains the leading cause of end‐stage kidney disease and a major risk factor for cardiovascular disease. Large cardiovascular... |
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SubjectTerms | Angiotensin Calcium calcium channel blockers Calcium Channel Blockers - pharmacology Calcium Channel Blockers - therapeutic use Cardiovascular diseases Clinical trials Diabetes Diabetes mellitus (non-insulin dependent) Diabetes Mellitus, Type 2 - drug therapy Diabetes Mellitus, Type 2 - physiopathology diabetic kidney disease Diabetic Nephropathies - prevention & control Diuretics Diuretics - pharmacology Diuretics - therapeutic use Drug Interactions Drugs Glomerular filtration rate Hemodynamics - drug effects Humans Kidney diseases Morbidity RAS inhibitors Renal Circulation - drug effects Renal function renal haemodynamic function Renin Renin-Angiotensin System - drug effects Review Reviews Risk factors SGLT2 inhibition Sodium-glucose cotransporter Sodium-Glucose Transporter 2 Inhibitors - pharmacology Sodium-Glucose Transporter 2 Inhibitors - therapeutic use type 2 diabetes humans Vasodilation |
Title | Renal haemodynamic and protective effects of renoactive drugs in type 2 diabetes: Interaction with SGLT2 inhibitors |
URI | https://onlinelibrary.wiley.com/doi/abs/10.1111%2Fnep.13839 https://www.ncbi.nlm.nih.gov/pubmed/33283420 https://www.proquest.com/docview/2509222792 https://www.proquest.com/docview/2467843705/abstract/ https://pubmed.ncbi.nlm.nih.gov/PMC8026736 |
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