Dapagliflozin - new solution in chronic kidney disease treatment
DOI:
https://doi.org/10.56782/pps.195Keywords:
dapagliflozin, chronic kidney disease, SGLT2i, nephrologyAbstract
Despite being developed relatively recently, sodium-glucose cotransporter 2 (SGLT2) inhibitors have proven to be versatile pharmaceuticals useful in treatment of diabetes mellitus, heart failure and chronic kidney disease. Extensive and ongoing studies confirm more and more of their beneficial effects on metabolic, cardiovascular and renal health. Most of the conducted studies focused on patients suffering from diabetes mellitus type 2. Recent study, DAPA - CKD, published in the New England Journal of Medicine, confirmed the beneficial effect of dapagliflozin on chronic kidney disease of any etiology. This discovery has cemented flozins’ status as nephroprotective drugs and led to a new indication of use for dapagliflozin - chronic kidney disease. In Poland treatment of chronic kidney disease with dapagliflozin is reimbursed in patients with chronic kidney disease with estimated glomerular filtration rate (eGFR) <60 ml/min/1.73m2, albuminuria or proteinuria who were treated with angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEi/ARB) for ≥4 weeks or with contraindications for ACEi/ARB therapy. Due to reimbursement, dapagliflozin therapy is financially available for a wide population of patients and, in light of recent discoveries, should be considered by clinicians.
Downloads
References
Mende, C.W. Chronic Kidney Disease and SGLT2 Inhibitors: A Review of the Evolving Treatment Landscape. Adv. Ther. 2022, 39(1), 148-164. DOI: 10.1007/s12325-021-01994-2 DOI: https://doi.org/10.1007/s12325-021-01994-2
Rieg, T.; Vallon, V. Development of SGLT1 and SGLT2 inhibitors. Diabetologia 2018, 61(10), 2079-2086. DOI: 10.1007/s00125-018-4654-7 DOI: https://doi.org/10.1007/s00125-018-4654-7
Jasleen, B.; Vishal, G.K.; Sameera, M.; Fahad, M.; Brendan, O.; Deion, S.; Pemminati S. Sodium-Glucose Cotransporter 2 (SGLT2) Inhibitors: Benefits Versus Risk. Cureus. 2023, 15(1), Art. No: e33939. DOI: 10.7759/cureus.33939 DOI: https://doi.org/10.7759/cureus.33939
Lee, P.C.; Ganguly, S.; Goh, S.Y. Weight loss associated with sodium-glucose cotransporter-2 inhibition: a review of evidence and underlying mechanisms. Obes. Rev. 2018, 19, 1630–1641. DOI: 10.1111/obr.12755. DOI: https://doi.org/10.1111/obr.12755
Thomas, M.C.; Cherney, D.Z.I. The actions of SGLT2 inhibitors on metabolism, renal function and blood pressure. Diabetologia 2018, 61, 2098–2107. DOI: 10.1007/s00125-018-4669-0. DOI: https://doi.org/10.1007/s00125-018-4669-0
Heerspink, H.J.; Perkins, B.A.; Fitchett, D.H. et al. Sodium glucose cotransporter 2 inhibitors in the treatment of diabetes mellitus: cardiovascular and kidney effects, potential mechanisms, and clinical applications. Circulation 2016, 134, 752–772. DOI: 10.1161/CIRCULATIONAHA.116.021887 DOI: https://doi.org/10.1161/CIRCULATIONAHA.116.021887
Sano, M.; Takei, M.; Shiraishi, Y.; Suzuki, Y. Increased Hematocrit During Sodium-Glucose Cotransporter 2 Inhibitor Therapy Indicates Recovery of Tubulointerstitial Function in Diabetic Kidneys. J. Clin. Med. Res. 2016, 8(12), 844-847 DOI: 10.14740/jocmr2760w DOI: https://doi.org/10.14740/jocmr2760w
Perkovic, V.; Jardine, M.J.; Neal, B.; Bompoint, S.; Heerspink, H.J.L.; Charytan, D.M.; Edwards, R.; Agarwal, R.; Bakris, G.; Bull, S.; Cannon, C.P.; Capuano, G.; Chu, P.L.; de Zeeuw, D.; Greene, T.; Levin, A.; Pollock, C.; Wheeler, D.C.; Yavin, Y.; Zhang, H.; Zinman, B.; Meininger, G.; Brenner, B.M.; Mahaffey, K.W.; CREDENCE Trial Investigators. Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy. N. Engl. J. Med. 2019, 380(24), 2295-2306. DOI: 10.1056/NEJMoa1811744 DOI: https://doi.org/10.1056/NEJMoa1811744
Webster, A.C.; Nagler, E.V.; Morton, R.L.; Masson, P. Chronic Kidney Disease. Lancet 2017, 389(10075), 1238-1252. DOI: 10.1016/S0140-6736(16)32064-5 DOI: https://doi.org/10.1016/S0140-6736(16)32064-5
Stevens, L.A.; Schmid, C.H.; Greene, T.; Zhang, Y.L.; Beck, G.J.; Froissart, M.; Hamm, L.L.; Lewis, J.B.; Mauer, M.; Navis, G.J.; Steffes, M.W.; Eggers, P.W.; Coresh, J.; Levey, A.S. Comparative performance of the CKD Epidemiology Collaboration (CKD-EPI) and the Modification of Diet in Renal Disease (MDRD) Study equations for estimating GFR levels above 60 mL/min/1.73 m2. Am. J. Kidney Dis. 2010, 56(3), 486-95. DOI: 10.1053/j.ajkd.2010.03.026 DOI: https://doi.org/10.1053/j.ajkd.2010.03.026
Delanaye, P.; Cavalier, E.; Pottel, H.; Stehlé, T. New and old GFR equations: a European perspective. Clin. Kidney J. 2023, 16(9), 1375-1383. DOI: 10.1093/ckj/sfad039 DOI: https://doi.org/10.1093/ckj/sfad039
Michels, W.M.; Grootendorst, D.C.; Verduijn, M.; Elliott, E.G.; Dekker, F.W.; Krediet, R.T. Performance of the Cockcroft-Gault, MDRD, and new CKD-EPI formulas in relation to GFR, age, and body size. Clin. J. Am. Soc. Nephrol. 2010, 5(6), 1003-9. doi: 10.2215/CJN.06870909 DOI: https://doi.org/10.2215/CJN.06870909
KDIGO 2021 Clinical Practice Guideline for the Management of Blood Pressure in Chronic Kidney Disease. Avaliable online: https://www.kidney-international.org/article/S0085-2538(20)31270-9/fulltext#secsectitle0015 (accessed on March 13, 2024)
MacRae, C.; Mercer, S.W.; Guthrie, B.; Henderson, D. Comorbidity in chronic kidney disease: a large cross-sectional study of prevalence in Scottish primary care. Br. J. Gen. Pract. 2021, 71(704), Art. No: e243-e249. DOI: 10.3399/bjgp20X714125 DOI: https://doi.org/10.3399/bjgp20X714125
Hill, N.R.; Fatoba, S.T.; Oke, J.L.; Hirst, J.A.; O'Callaghan, C.A.; Lasserson, D.S.; Hobbs, F.D. Global Prevalence of Chronic Kidney Disease - A Systematic Review and Meta-Analysis. PLoS One 2016, 11(7), Art. No: e0158765. DOI: 10.1371/journal.pone.0158765 DOI: https://doi.org/10.1371/journal.pone.0158765
Turin, T.C.; Tonelli, M.; Manns, B.J.; Ravani, P.; Ahmed, S.B.; Hemmelgarn, B.R. Chronic kidney disease and life expectancy. Nephrol. Dial. Transplant. 2012, 27(8), 3182-6. DOI: 10.1093/ndt/gfs052 DOI: https://doi.org/10.1093/ndt/gfs052
Kovesdy, C.P. Epidemiology of chronic kidney disease: an update 2022. Kidney Int. Suppl. 2022, 12(1), 7-11. DOI: 10.1016/j.kisu.2021.11.003 DOI: https://doi.org/10.1016/j.kisu.2021.11.003
Bailey, C.J.; Day, C.; Bellary, S.; Renal Protection with SGLT2 Inhibitors: Effects in Acute and Chronic Kidney Disease. Curr. Diab. Rep. 2022, 22(1), 39-52. https://doi.org/10.1007/s11892-021-01442-z DOI: https://doi.org/10.1007/s11892-021-01442-z
Yau, K.; Dharia, A.; Alrowiyti, I.; Cherney, D.Z.I. Prescribing SGLT2 Inhibitors in Patients With CKD: Expanding Indications and Practical Considerations. Kidney Int. Rep. 2022, 7(7), 1463-1476. DOI: 10.1016/j.ekir.2022.04.094 DOI: https://doi.org/10.1016/j.ekir.2022.04.094
Charakterystyka Produktu Leczniczego - Forxiga. Available Online: https://www.ema.europa.eu/en/documents/product-information/forxiga-epar-product-information_en.pdf (accessed on March 10, 2024).
Heerspink, H.J.L.; Stefánsson, B.V.; Correa-Rotter, R.; Chertow, G.M.; Greene, T.; Hou, F.F.; Mann, J.F.E.; McMurray, J.J.V.; Lindberg, M.; Rossing, P.; Sjöström, C.D.; Toto, R.D.; Langkilde, A.M.; Wheeler, D.C; DAPA-CKD Trial Committees and Investigators. Dapagliflozin in Patients with Chronic Kidney Disease. N. Engl. J. Med. 2020, 383(15), 1436-1446. DOI: 10.1056/NEJMoa2024816 DOI: https://doi.org/10.1056/NEJMoa2024816
Herrington, W.G.; Staplin, N.; Wanner, C.; Green, J.B.; Hauske, S.J.; Emberson, J.R.; Preiss, D.; Judge, P.; Mayne, K.J.; Ng, S.Y.A.; Sammons, E.; Zhu, D.; Hill, M.; Stevens, W.; Wallendszus, K.; Brenner, S.; Cheung, A.K.; Liu, Z.H.; Li, J.; Hooi, L.S.; Liu, W.; Kadowaki, T.; Nangaku, M.; Levin, A.; Cherney, D.; Maggioni, A.P.; Pontremoli, R.; Deo, R.; Goto, S.; Rossello, X.; Tuttle, K.R.; Steubl, D.; Petrini, M.; Massey, D.; Eilbracht, J.; Brueckmann, M.; Landray, M.J.; Baigent, C.; Haynes, R. Empagliflozin in Patients with Chronic Kidney Disease. N. Engl. J. Med. 2023, 388(2), 117-127. DOI: 10.1056/NEJMoa2204233 DOI: https://doi.org/10.1056/NEJMoa2204233
Liu, J.; Cui, J.; Fang, X.; Chen, J.; Yan, W.; Shen, Q.; Xu, H. Efficacy and Safety of Dapagliflozin in Children With Inherited Proteinuric Kidney Disease: A Pilot Study. Kidney Int. Rep. 2021, 7(3), 638-641. DOI: 10.1016/j.ekir.2021.12.019 DOI: https://doi.org/10.1016/j.ekir.2021.12.019
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Maciej Bara, Jakub Starownik, Jakub Szydło, Patryk Gryszkiewicz, Jakub Nieznański
This work is licensed under a Creative Commons Attribution 4.0 International License.
For all articles published in Prospects in Pharmaceutical Sciences copyright is retained by the authors. The journal publishes articles in the Open Access policy, within the CC BY 4.0 licence.
This is a human-readable summary of (and not a substitute for) the license. Disclaimer.
You are free to:
Share — copy and redistribute the material in any medium or format
Adapt — remix, transform, and build upon the material for any purpose, even commercially.
The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
Notices:
You do not have to comply with the license for elements of the material in the public domain or where your use is permitted by an applicable exception or limitation.
No warranties are given. The license may not give you all of the permissions necessary for your intended use. For example, other rights such as publicity, privacy, or moral rights may limit how you use the material.
How to Cite
