Newer possibilities of slowing the development of chronic kidney disease and the role of dapagliflozin
Authors:
Jan Vachek 1,2; Kateřina Oulehle 2; Hana Ciferská 3; Oskar Zakiyanov 1; Vladimír Tesař 1
Authors‘ workplace:
Klinika nefrologie 1. LF UK a VFN v Praze
1; Interní oddělení a nefrologická ambulance, Klatovská nemocnice, a. s., Klatovy
2; Revmatologická klinika 1. LF UK a Revmatologický ústav, Praha
3
Published in:
AtheroRev 2022; 7(3): 140-146
Category:
Reviews
Overview
According to current estimates, chronic kidney disease will be the 5th leading cause of death worldwide by 2040. The prevalence of chronic kidney disease increases with age and mainly affects patients with obesity, diabetes mellitus and hypertension. The main goal of treating chronic kidney disease is to delay the progression of the disease. Established markers of progression of renal impairment are glomerular filtration rate and albuminuria. Pharmacological blockade of the renin-angiotensin-aldosterone system (RAAS) by angiotensin converting enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARBs) has been the basis of medicamentous slowing of the progression of renal disease for many years. Current recommendations from the Kidney Disease: Improving Global Outcomes (KDIGO) initiative recommend the use of ACEi or ARB in both diabetic and non-diabetic patients with moderate or severe albuminuria. In recent years, a group of drugs known as sodium-glucose transporter 2 (SGLT2i) inhibitors has gained ground in the field of cardioprotection and nephroprotection. Their protective effects are manifested independently of a decrease in blood glucose. SGLT2i will soon be part of the recommendations for the treatment of non-diabetic kidney disease. The first representative of this group of substances, dapagliflozin, is already approved in the Czech Republic for the treatment of chronic kidney disease in adults with and without type 2 diabetes mellitus.
Keywords:
dapagliflozin – diabetes mellitus – chronic kidney disease – renin-angiotensin-aldosterone system – sodiumglucose transporter 2 inhibitors
Sources
1. Levin A, Stevens PE, Bilous RW et al. [Kidney disease: Improving global outcomes (KDIGO) CKD work group]. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Suppl 2013; 3(1): 1–150. Dostupné z WWW: <https://www.sciencedirect.com/journal/kidney-international-supplements/vol/3/issue/1>.
2. Kalantar-Zadeh K, Jafar TH, Nitsch D et al. Chronic kidney disease. Lancet 2021; 398(10302): 786–802. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140–6736(21)00519–5>.
3. Malhotra R, Craven T, Ambrosius WT et al. [SPRINT Research Group].Effects of intensive blood pressure lowering on kidney tubule injury in CKD: a longitudinal subgroup analysis in SPRINT. Am J Kidney Dis 2019; 73(1): 21–30. Dostupné z DOI: <http://dx.doi.org/10.1053/j.ajkd.2018.07.015>.
4. [Kidney Disease: Improving Global Outcomes (KDIGO) Blood Pressure Work Group]. KDIGO 2021 clinical practice guideline for the management of blood pressure in chronic kidney disease. Kidney Int 2021; 99(3S): S1–S87. Dostupné z DOI: <http://dx.doi.org/10.1016/j.kint.2020.11.003>.
5. Juraschek SP, Taylor AA, Wright JT jr et al. [SPRINT Research Group]. Orthostatic Hypotension, Cardiovascular Outcomes, and Adverse Events: Results From SPRINT. Hypertension 2020; 75(3): 660–667. Dostupné z DOI: <http://dx.doi.org/10.1161/HYPERTENSIONAHA.119.14309>.
6. Sarafidis PA, Ruilope LM. Cardiorenal disease development under chronic renin-angiotensin-aldosterone system suppression. J Renin Angiotensin Aldosterone Syst 2012; 13(1): 217–219. Dostupné z DOI: <http://dx.doi.org/10.1177/1470320312439140>.
7. Lewis EJ, Hunsicker LG, Bain RP et al. The effect of angiotensin-converting-enzyme inhibition on diabetic nephropathy. The Collaborative Study Group. N Engl J Med 1993; 329(20): 1456–1462. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJM199311113292004>.
8. Brenner BM, Cooper ME, de Zeeuw D et al. [RENAAL Study Investigators]. Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy. N Engl J Med 2001; 345(12): 861–869. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa011161>.
9. Lewis EJ, Hunsicker LG, Clarke WR et al. [Collaborative Study Group]. Renoprotective effect of the angiotensin-receptor antagonist irbesartan in patients with nephropathy due to type 2 diabetes. N Engl J Med 2001; 345(12): 851–860. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa011303>.
10. Parving HH, Brenner BM, McMurray JJ et al. [ALTITUDE Investigators]. Cardiorenal end points in a trial of aliskiren for type 2 diabetes. N Engl J Med 2012; 367(23): 2204–2213. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1208799>.
11. Fried LF, Emanuele N, Zhang JH et al. [VA NEPHRON-D Investigators]. Combined angiotensin inhibition for the treatment of diabetic nephropathy. N Engl J Med 2013; 369(20): 1892–1903. Dostupné z DOI: <http://.dx.doi.org/10.1056/NEJMoa1303154>.
12. Bomback AS, Kshirsagar AV, Amamoo MA et al. Change in proteinuria after adding aldosterone blockers to ACE inhibitors or angiotensin receptor blockers in CKD: a systematic review. Am J Kidney Dis 2008; 51(2): 199–211. Dostupné z DOI: <http://dx.doi.org/10.1053/j.ajkd.2007.10.040>.
13. Bakris GL, Agarwal R, Anker SD et al. [FIDELIO-DKD Investigators]. Effect of Finerenone on Chronic Kidney Disease Outcomes in Type 2 Diabetes. N Engl J Med 2020; 383(23): 2219–2229. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa2025845>.
14. Zannad F, Ferreira JP, Pocock SJ et al. SGLT2 inhibitors in patients with heart failure with reduced ejection fraction: a meta-analysis of the EMPEROR-Reduced and DAPA-HF trials. Lancet 2020; 396(10254): 819–829. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140–6736(20)31824–9>.
15. McMurray JJ, Solomon SD, Inzucchi SE et al. [DAPA-HF Trial Committees and Investigators]. Dapagliflozin in patients with heart failure and reduced ejection fraction. N Engl J Med 2019; 381(21): 1995–2008. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1911303>.
16. Jhund PS, Solomon SD, Docherty KF et al. Efficacy of dapagliflozin on renal function and outcomes in patients with heart failure with reduced ejection fraction: results of DAPA-HF. Circulation 2021; 143(4): 298–309. Dostupné z DOI: <http://dx.doi.org/10.1161/CIRCULATIONAHA.120.050391>.
17. Packer M, Anker SD, Butler J et al. [EMPEROR- Reduced Trial Investigators]. Cardiovascular and renal outcomes with empagliflozin in heart failure. N Engl J Med 2020; 383(15): 1413–1424. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa2022190>.
18. Neal B, Perkovic V, Mahaffey KW et al. [CANVAS Program Collaborative Group]. Canagliflozin and cardiovascular and renal events in type 2 diabetes. N Engl J Med 2017; 377(7): 644–657. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1611925>.
19. Cannon CP, Pratley R, Dagogo-Jack S et al. [VERTIS CV Investigators]. Cardiovascular Outcomes with Ertugliflozin in Type 2 Diabetes. N Engl J Med 2020; 383(15): 1425–1435. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa2004967>.
20. Bhatt DL, Szarek M, Pitt B et al. [SCORED Investigators]. Sotagliflozin in Patients with Diabetes and Chronic Kidney Disease. N Engl J Med 2021; 384(2): 129–139. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa2030186>.
21. Zelniker TA, Braunwald E. Mechanisms of cardiorenal effects of sodium-glucose co-transporter 2 inhibitors: JACC state-of-the-Art review. J Am Coll Cardiol 2020; 75(4):422–434. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jacc.2019.11.031>.
22. Ohkuma T, Jun M, Rodgers A et al. [ADVANCE Collaborative Group]. Acute increases in serum creatinine after starting angiotensin-converting enzyme inhibitor-based therapy and effects of its continuation on major clinical outcomes in type 2 diabetes mellitus. Hypertension 2019; 73(1): 84–91. Dostupné z DOI: <http://dx.doi.org/10.1161/HYPERTENSIONAHA.118.12060>.
23. Zhao M, Sun S, Huang Z et al. Network meta-analysis of novel glucose--lowering drugs on risk of acute kidney injury. Clin J Am Soc Nephrol 2020; 16(1): 70–78. Dostupné z DOI: <http://dx.doi.org/10.2215/CJN.11220720>.
24. Perkovic V, Jardine MJ, Neal B et al. [CREDENCE Trial Investigators]. Canagliflozin and renal outcomes in type 2 diabetes and nephropathy. N Engl J Med 2019; 380(24): 2295–2306. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1811744>.
25. Heerspink HJL, Stefánsson BV, Correa-Rotter R et al. [DAPA- CKD Trial Committees and Investigators]. Dapagliflozin in patients with chronic kidney disease. N Engl J Med 2020; 383(15): 1436–1446. Dostupné z DOI:<http://dx.doi.org/10.1056/NEJMoa2024816>.
26. Wheeler DC, Stefánsson BV, Jongs N et al. [DAPA-CKD Trial Committees and Investigators]. Effects of dapagliflozin on major adverse kidney and cardiovascular events in patients with diabetic and non-diabetic chronic kidney disease: a prespecified analysis from the DAPA-CKD trial. Lancet Diabetes Endocrinol 2021; 9(1): 22–31. Dostupné z DOI: <http://dx.doi.org/10.1016/S2213–8587(20)30369–7>.
27. Wheeler DC, Toto RD, Stefánsson BV et al. [ DAPA- CKD Trial Committees and Investigators]. A pre-specified analysis of the DAPA-CKD trial demonstrates the effects of dapagliflozin on major adverse kidney events in patients with IgA nephropathy. Kidney Int 2021; 100(1): 215–224. Dostupné z DOI: <http://dx.doi.org/10.1016/j.kint.2021.03.033>.
28. Rauen T, Wied S, Fitzner C et al. [STOP- IgAN Investigators]. After ten years of follow-up, no difference between supportive care plus immunosuppression and supportive care alone in IgA nephropathy. Kidney Int 2020; 98(4): 1044–1052. Dostupné z DOI: <http://dx.doi.org/10.1016/j.kint.2020.04.046>.
29. Chertow GM, Vart P, Jongs N et al. [DAPA-CKD Trial Committees and Investigators]. Effects of Dapagliflozin in Stage 4 Chronic Kidney Disease. J Am Soc Nephrol 2021; 32(9): 2352–2361. Dostupné z DOI: <http://dx.doi.org/10.1681/ASN.2021020167>.
30. Rosenstock J, Perkovic V, Johansen OE et al. [CARMELINA Investigators]. Effect of linagliptin vs placebo on major cardiovascular events in adults with type 2 diabetes and high cardiovascular and renal risk: the CARMELINA randomized clinical trial. JAMA 2019; 321(1): 69–79. Dostupné z DOI: <http://dx.doi.org/10.1001/jama.2018.18269>.
31. Zelniker TA, Wiviott SD, Raz I et al. Comparison of the effects of glucagon-like peptide receptor agonists and sodium-glucose co-transporter 2 inhibitors for prevention of major adverse cardiovascular and renal outcomes in type 2 diabetes mellitus. Circulation 2019; 139(17): 2022–2031. Dostupné z DOI: <http://dx.doi.org/10.1161/CIRCULATIONAHA.118.038868>.
32. Riddle MC, Gerstein HC, Xavier D et al. Efficacy and Safety of Dulaglutide in Older Patients: A post hoc Analysis of the REWIND trial. J Clin Endocrinol Metab 2021; 106(5): 1345–1351. Dostupné z DOI: <http://dx.doi.org/10.1210/clinem/dgab065>.
33. Čertíková Chábová V, Zakiyanov O. Sodium Glucose Co-transporter-2 Inhibitors: Spotlight on Favorable Effects on Clinical Outcomes beyond Diabetes. Int J Mol Sci 2022; 23(5): 2812. Dostupné z DOI: <http://dx.doi.org/10.3390/ijms23052812>.
34. Tesař V, Vachek J. Nové možnosti ovlivnění progrese diabetického onemocnění ledvin [Gliflozins slow down the progression of diabetic kidney disease]. Vnitr Lek 2017; 63(10): 723–727.
Labels
Angiology Diabetology Internal medicine Cardiology General practitioner for adultsArticle was published in
Athero Review
2022 Issue 3
Most read in this issue
- Bempedoic acid – a new drug to lower LDL-cholesterol level
- Newer possibilities of slowing the development of chronic kidney disease and the role of dapagliflozin
- Statement CSAT on Consensus EAS 2021: Triglyceride-rich lipoproteins and their remnants – metabolic insights, role in atherosclerotic cardiovascular disease, and emerging therapeutic strategies
- XXXVI. konference o hyperlipoproteinemiích – Šobrův den 2022