Use of sodium‐glucose co‐transporter‐2 inhibitors in Asian patients with type 2 diabetes and kidney disease: An Asian perspective and expert recommendations

Early onset of type 2 diabetes and a high prevalence of co‐morbidities predispose the Asian population to a high risk for, and rapid progression of, diabetic kidney disease (DKD). Apart from renin‐angiotensin system inhibitors, sodium‐glucose co‐transporter‐2 (SGLT‐2) inhibitors have been shown to d...

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Autores principales: Khoo, Chin Meng, Deerochanawong, Chaicharn, Chan, Siew Pheng, Matawaran, Bien, Sheu, Wayne Huey‐Herng, Chan, Juliana, Mithal, Ambrish, Luk, Andrea, Suastika, Ketut, Yoon, Kun‐Ho, Ji, Linong, Man, Nguyen Huu, Pollock, Carol
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Blackwell Publishing Ltd 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7839543/
https://www.ncbi.nlm.nih.gov/pubmed/33155749
http://dx.doi.org/10.1111/dom.14251
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author Khoo, Chin Meng
Deerochanawong, Chaicharn
Chan, Siew Pheng
Matawaran, Bien
Sheu, Wayne Huey‐Herng
Chan, Juliana
Mithal, Ambrish
Luk, Andrea
Suastika, Ketut
Yoon, Kun‐Ho
Ji, Linong
Man, Nguyen Huu
Pollock, Carol
author_facet Khoo, Chin Meng
Deerochanawong, Chaicharn
Chan, Siew Pheng
Matawaran, Bien
Sheu, Wayne Huey‐Herng
Chan, Juliana
Mithal, Ambrish
Luk, Andrea
Suastika, Ketut
Yoon, Kun‐Ho
Ji, Linong
Man, Nguyen Huu
Pollock, Carol
author_sort Khoo, Chin Meng
collection PubMed
description Early onset of type 2 diabetes and a high prevalence of co‐morbidities predispose the Asian population to a high risk for, and rapid progression of, diabetic kidney disease (DKD). Apart from renin‐angiotensin system inhibitors, sodium‐glucose co‐transporter‐2 (SGLT‐2) inhibitors have been shown to delay renal disease progression in patients with DKD. In this review article, we consolidate the existing literature on SGLT‐2 inhibitor use in Asian patients with DKD to establish contemporary guidance for clinicians. We extensively reviewed recommendations from international and regional guidelines, data from studies on Asian patients with DKD, global trials (DAPA‐CKD, CREDENCE and DELIGHT) and cardiovascular outcomes trials. In patients with DKD, SGLT‐2 inhibitor therapy significantly reduced albuminuria and the risk of hard renal outcomes (defined as the onset of end‐stage kidney disease, substantial decline in renal function from baseline and renal death), cardiovascular outcomes and hospitalization for heart failure. In all the cardiovascular and renal outcomes trials, there was an initial decline in the estimated glomerular filtration rate (eGFR), which was followed by a slowing in the decline of renal function compared with that seen with placebo. Despite an attenuation in glucose‐lowering efficacy in patients with low eGFR, there were sustained reductions in body weight and blood pressure, and an increase in haematocrit. Based on the available evidence, we conclude that SGLT‐2 inhibitors represent an evidence‐based therapeutic option for delaying the progression of renal disease in Asian patients with DKD and preserving renal function in patients at high risk of kidney disease.
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spelling pubmed-78395432021-02-01 Use of sodium‐glucose co‐transporter‐2 inhibitors in Asian patients with type 2 diabetes and kidney disease: An Asian perspective and expert recommendations Khoo, Chin Meng Deerochanawong, Chaicharn Chan, Siew Pheng Matawaran, Bien Sheu, Wayne Huey‐Herng Chan, Juliana Mithal, Ambrish Luk, Andrea Suastika, Ketut Yoon, Kun‐Ho Ji, Linong Man, Nguyen Huu Pollock, Carol Diabetes Obes Metab Review Article Early onset of type 2 diabetes and a high prevalence of co‐morbidities predispose the Asian population to a high risk for, and rapid progression of, diabetic kidney disease (DKD). Apart from renin‐angiotensin system inhibitors, sodium‐glucose co‐transporter‐2 (SGLT‐2) inhibitors have been shown to delay renal disease progression in patients with DKD. In this review article, we consolidate the existing literature on SGLT‐2 inhibitor use in Asian patients with DKD to establish contemporary guidance for clinicians. We extensively reviewed recommendations from international and regional guidelines, data from studies on Asian patients with DKD, global trials (DAPA‐CKD, CREDENCE and DELIGHT) and cardiovascular outcomes trials. In patients with DKD, SGLT‐2 inhibitor therapy significantly reduced albuminuria and the risk of hard renal outcomes (defined as the onset of end‐stage kidney disease, substantial decline in renal function from baseline and renal death), cardiovascular outcomes and hospitalization for heart failure. In all the cardiovascular and renal outcomes trials, there was an initial decline in the estimated glomerular filtration rate (eGFR), which was followed by a slowing in the decline of renal function compared with that seen with placebo. Despite an attenuation in glucose‐lowering efficacy in patients with low eGFR, there were sustained reductions in body weight and blood pressure, and an increase in haematocrit. Based on the available evidence, we conclude that SGLT‐2 inhibitors represent an evidence‐based therapeutic option for delaying the progression of renal disease in Asian patients with DKD and preserving renal function in patients at high risk of kidney disease. Blackwell Publishing Ltd 2020-11-20 2021-02 /pmc/articles/PMC7839543/ /pubmed/33155749 http://dx.doi.org/10.1111/dom.14251 Text en © 2020 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Review Article
Khoo, Chin Meng
Deerochanawong, Chaicharn
Chan, Siew Pheng
Matawaran, Bien
Sheu, Wayne Huey‐Herng
Chan, Juliana
Mithal, Ambrish
Luk, Andrea
Suastika, Ketut
Yoon, Kun‐Ho
Ji, Linong
Man, Nguyen Huu
Pollock, Carol
Use of sodium‐glucose co‐transporter‐2 inhibitors in Asian patients with type 2 diabetes and kidney disease: An Asian perspective and expert recommendations
title Use of sodium‐glucose co‐transporter‐2 inhibitors in Asian patients with type 2 diabetes and kidney disease: An Asian perspective and expert recommendations
title_full Use of sodium‐glucose co‐transporter‐2 inhibitors in Asian patients with type 2 diabetes and kidney disease: An Asian perspective and expert recommendations
title_fullStr Use of sodium‐glucose co‐transporter‐2 inhibitors in Asian patients with type 2 diabetes and kidney disease: An Asian perspective and expert recommendations
title_full_unstemmed Use of sodium‐glucose co‐transporter‐2 inhibitors in Asian patients with type 2 diabetes and kidney disease: An Asian perspective and expert recommendations
title_short Use of sodium‐glucose co‐transporter‐2 inhibitors in Asian patients with type 2 diabetes and kidney disease: An Asian perspective and expert recommendations
title_sort use of sodium‐glucose co‐transporter‐2 inhibitors in asian patients with type 2 diabetes and kidney disease: an asian perspective and expert recommendations
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7839543/
https://www.ncbi.nlm.nih.gov/pubmed/33155749
http://dx.doi.org/10.1111/dom.14251
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