The SGLT2 Inhibitor Empagliflozin Might Be a New Approach for the Prevention of Acute Kidney Injury

Three randomized control trials (Canagliflozin Cardiovascular Assessment Study, Empagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients [EMPA-REG OUTCOME], and Dapagliflozin Effect on Cardiovascular Events-Thrombolysis in Myocardial Infarction 58 [DECLARE-TIMI 58]) showed that the sodium-glucose co-transporter 2 (SGLT2) inhibitors, originally developed as glucose-lowering drugs, are associated with a lower rate of adverse renal outcomes, such as need for renal replacement therapy, doubling of serum creatinine, and loss of glomerular filtration rate (GFR) compared to those in placebo groups. Besides, canagliflozin and empagliflozin also showed a lower risk of progression to macroalbuminuria. The EMPA-REG OUTCOME trial and DECLARE-TIMI 58 trial also indicated that these SGLT2 inhibitors might have beneficial effects on the prevention of acute kidney injury. The United States Food and Drug Administration (FDA) warned of the risk of acute kidney injury for canagliflozin and dapagliflozin. We compared canagliflozin, empagliflozin, and dapagliflozin with respect to chemical structure and pharmacological properties, to explain the observed differences in preventing acute kidney injury, and put forward the hypotheses of the potential mechanisms of different effects of SGLT2 inhibitors on acute kidney injury. Given the raising clinical use of SGLT2 inhibitors, our review should stimulate further basic science and clinical studies in order to definitively ...
Source: Kidney and Blood Pressure Research - Category: Urology & Nephrology Source Type: research

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The sodium-dependent glucose co-transporter (SGLT-2) inhibitors are the newest class of oral agents in the armoury of the physician to combat type 2 diabetes mellitus (T2DM). The significant reduction in cardiovascular outcomes with all three SGLT2- inhibitors is now well documented (1-3), as is the reduction in chronic kidney disease (CKD) outcomes with canagliflozin (4). The effect of another SGLT-2 inhibitor, dapagliflozin, on long term CKD outcomes is the subject of a secondary analysis of the Dapagliflozin Effect on Cardiovascular Events –Thrombolysis In Myocardial Infarction 58 (DECLARE-TIMI 58) trial, recently...
Source: Kidney International - Category: Urology & Nephrology Authors: Tags: Nephrology Digest Source Type: research
AbstractIntroductionThe results of recently completed cardiovascular outcomes trials in patients with type 2 diabetes mellitus (T2DM) suggest that sodium-glucose cotransporter-2 (SGLT2) inhibitors and glucagon-like peptide (GLP) 1 receptor agonists have enhanced cardioprotective properties in patients with established cardiovascular disease (eCVD), but to a lesser degree in those without eCVD. SGLT2 inhibitors appear to be particularly beneficial in patients with heart failure. As recent data for the UK are lacking, we undertook to identify the percentage of T2DM patients with eCVD and heart failure in the UK.MethodsThis w...
Source: Diabetes Therapy - Category: Endocrinology Source Type: research
AbstractIntroductionA recent study demonstrated that large glucose fluctuations were associated with an increased incidence of cardiovascular disease (CVD) in patients with type 2 diabetes mellitus (T2DM) and acute myocardial infarction. However, it is unknown whether glucose fluctuations are related to the incidence of CVD or the progression of atherosclerosis in patients with T2DM with no apparent history of CVD. In this protocol, we will be investigating the relationships of glucose fluctuations evaluated by continuous glucose monitoring (CGM) to the incidence of composite cardiovascular events and the progression of at...
Source: Diabetes Therapy - Category: Endocrinology Source Type: research
In conclusion, older adults exhibited decreased markers of UPR activation and reduced coordination with autophagy and SC-associated gene transcripts following a single bout of unaccustomed resistance exercise. In contrast, young adults demonstrated strong coordination between UPR genes and key regulatory gene transcripts associated with autophagy and SC differentiation in skeletal muscle post-exercise. Taken together, the present findings suggest a potential age-related impairment in the post-exercise transcriptional response that supports activation of the UPR and coordination with other exercise responsive pathways (i.e....
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
Authors: Xing Z, Tang L, Chen J, Pei J, Chen P, Fang Z, Zhou S, Hu X Abstract BACKGROUND: Previous studies have found that predicted fat mass and lean body mass may act differently on adverse events. However, the cardiovascular prognostic value of lean body mass and fat mass in patients with type 2 diabetes mellitus (T2DM) has not yet been investigated. We sought to investigate the relation between predicted lean body mass or fat mass and the risk of cardiovascular disease in patients with T2DM. METHODS: We conducted a post hoc analysis of data from the Action to Control Cardiovascular Risk in Diabetes (ACCORD)...
Source: Canadian Medical Association Journal - Category: General Medicine Tags: CMAJ Source Type: research
Publication date: Available online 1 September 2019Source: The LancetAuthor(s): Deepak L Bhatt, Philippe Gabriel Steg, Shamir R Mehta, Lawrence A Leiter, Tabassome Simon, Kim Fox, Claes Held, Marielle Andersson, Anders Himmelmann, Wilhelm Ridderstråle, Jersey Chen, Yang Song, Rafael Diaz, Shinya Goto, Stefan K James, Kausik K Ray, Alexander N Parkhomenko, Mikhail N Kosiborod, Darren K McGuire, Robert A HarringtonSummaryBackgroundPatients with stable coronary artery disease and diabetes with previous percutaneous coronary intervention (PCI), particularly those with previous stenting, are at high risk of ischaemic even...
Source: The Lancet - Category: General Medicine Source Type: research
Conclusions: The estimated economic data are required for policy decisions to optimize resource allocation and to evaluate different approaches for disease management. PMID: 31456456 [PubMed - as supplied by publisher]
Source: Expert Review of Pharmacoeconomics and Outcomes Research - Category: Health Management Tags: Expert Rev Pharmacoecon Outcomes Res Source Type: research
Conclusions: Newly detected dysglycaemia, including manifest diabetes, is common in patients with acute MI. Cathepsin D improved the prediction of dysglycaemia, which may be helpful in the a priori risk determination of diabetes as a motivation for confirmatory OGTT. PMID: 31429631 [PubMed - as supplied by publisher]
Source: Upsala Journal of Medical Sciences - Category: General Medicine Authors: Tags: Ups J Med Sci Source Type: research
Authors: Abdaly MS, Azizi MS, Wijaya IP, Nugroho P, Purnamasari D Abstract Cardiovascular disease (CVD) remain a leading cause of death globally. The concept of acute myocardial infarction in young adults was uncommon. Atherosclerosis is the leading cause of CVD, including myocardial infarction, stroke, heart failure and peripheral artery disease. This condition is initiated early in childhood and progressive in nature. CVD risk factors includes hypertension, dyslipidemia and obesity play a role in the development of atherosclerosis and  components in insulin resistance syndrome.One of many risk factors for in...
Source: Acta medica Indonesiana - Category: Internal Medicine Tags: Acta Med Indones Source Type: research
Conclusions: CGM is effective to detect asymptomatic and nocturnal hypoglycemia. Hypoglycemia is associated with an increased risk of non-fatal stroke, cardiovascular related death and total mortality. The cardiovascular mortality is dose-dependent on the severity of hypoglycemia.
Source: Frontiers in Endocrinology - Category: Endocrinology Source Type: research
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