Renoprotection with sodium‐glucose cotransporter‐2 inhibitors in children: Knowns and unknowns

Jiang, Buchun; Cheng, Zhiwen; Liu, Fei; Li, Qiuyu; Fu, Haidong; Mao, Jianhua

doi:10.1111/nep.13979

Cited by 7 publications

(4 citation statements)

References 42 publications

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“…Limited data on pediatric use, specifically dapagliflozin, indicate the need for cautious monitoring, especially concerning genital infections, UTIs, hypotension, DKA, and hypoglycemia. Despite a lower risk of lower limb amputation in children with diabetes, ongoing research is essential for a thorough evaluation of efficacy and safety in pediatric populations [66].…”

Section: Safety Profilementioning

confidence: 99%

Untitled

2024

Urin. Renal. Res.

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Chronic kidney disease (CKD) affects 10%-13% of the global population, necessitating innovative treatments. Empagliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor, shows promise by reducing glycated hemoglobin and benefiting kidney and cardiovascular health. By spotlighting renoprotective mechanisms like glucose control and anti-inflammatory effects, insights from trials such as EMPA-REG OUTCOME unveil decreased kidney disease progression, improved eGFR, and reduced albuminuria with empagliflozin. Safety profiles and comparisons: Evaluating safety profiles, potential adverse events, and comparisons with other SGLT2 inhibitors provides a nuanced perspective on the therapeutic potential of empagliflozin. The review emphasizes the importance of diverse CKD population studies, continuous safety monitoring, and exploring SGLT2 inhibitors in specific demographics. In summary, empagliflozin emerges as a versatile therapeutic option in the SGLT2 inhibitor class for CKD, reshaping disease management. Final thoughts: Ongoing research and vigilant monitoring are crucial for maximizing the potential of SGLT2 inhibitors, especially empagliflozin, to enhance patient well-being in CKD.

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Section: Safety Profilementioning

confidence: 99%

Untitled

2024

Urin. Renal. Res.

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“…ACE inhibitors and ARBs are first-line medications for hypertension control in children with CKD [148] and are effective and safe for proteinuria reduction [149]. Although pediatric studies are limited, similar encouraging results have been found in children treated with SGLT2 inhibitors [150‒153]. Considerable disparities exist in the capacity for pediatric kidney care between and within countries [154], which reduces opportunities to implement CKD prevention and treatment strategies.…”

Section: Inequities and Quality Of Kidney Care Across The Globementioning

confidence: 99%

Equity and Quality of Global Chronic Kidney Disease Care: What Are We Waiting for?

Luyckx,

Elmaghrabi,

Sahay

et al. 2023

Am J Nephrol

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Background: Chronic kidney disease (CKD) is an important but insufficiently recognized public health problem. Unprecedented advances in delaying progression of CKD and reducing kidney failure and death have been made in recent years, with the addition of the sodium glucose co-transporter 2 inhibitors and other newer medication to the established standard of care with inhibitors of the renin angiotensin system. Despite knowledge of these effective therapies, their prescription and use remains suboptimal globally, and more specially in low resource settings. Many challenges contribute to this gap between knowledge and translation into clinical care, which is even wider in lower resource settings across the globe. Implementation of guideline-directed care is hampered by lack of disease awareness, late or missed diagnosis, clinical inertia, poor quality care, cost of therapy, systemic biases, and lack of patient empowerment. All of these are exacerbated by the social determinants of health and global inequities. Summary CKD is a highly manageable condition but requires equitable and sustainable access to quality care supported by health policies, health financing, patient and healthcare worker education and affordability of medications and diagnostics. Key Messages The gap between the knowledge and tools to treat CKD and the implementation of optimal quality kidney care should no longer be tolerated. Advocacy, research and action are required to improve equitable access to sustainable quality care for CKD everywhere.

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“…On the contrary, the risk of lower limb amputation seems to be lower in children with diabetes. However, the available evidence in pediatrics did not underline serious adverse events ( 58 ).…”

Section: Safety Of Sglt2 Inhibitorsmentioning

confidence: 99%

Safety profile of sodium glucose co-transporter 2 (SGLT2) inhibitors: A brief summary

Mascolo

Napoli

Balzano

et al. 2022

Front. Cardiovasc. Med.

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A new therapeutic class of oral agents firstly used for the treatment of type 2 diabetes mellitus is represented by gliflozines or sodium-glucose co-transporter 2 (SGLT2) inhibitors. SGLT2 inhibitors might be effective alone or in combination with any other drugs. This therapeutic class currently includes five agents: canagliflozin, dapagliflozin, empagliflozin, ertugliflozin, and sotagliflozin. SGLT2 inhibitors prevent the renal reabsorption of filtered glucose and sodium by blocking the SGLT2 co-transporters in the proximal convoluted renal tubule, facilitating glucose excretion in the urine (glycosuria) and lowering blood glucose levels. SGLT2 inhibitors have also shown to have pleiotropic effects and determine cardiovascular and renal prevention, thus leading to an extension of their therapeutic indication to include the heart failure. Despite their clinical benefits, warnings about adverse events have been implemented by Regulatory Agencies in the product's information since their introduction to the market. In particular, SGLT2 inhibitors have shown a strong impact on a high number of risk factors. They can cause hypoglycaemia, hypotension, lower limb amputation, fractures, genito-urinary infections, and diabetic ketoacidosis with different frequencies of onset. Despite some of these events are rare, they can lead to serious and dangerous complications, highlighting the importance of a strict monitoring of patients. Overall, SLGT-2 inhibitors are effective antidiabetic drugs with favorable advantages in renal and cardiovascular protection, and with a generally well-tolerated safety profile. This review aims to summarize the safety profile of SGLT2 inhibitors available in the market.

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Renoprotection with sodium‐glucose cotransporter‐2 inhibitors in children: Knowns and unknowns

Cited by 7 publications

References 42 publications

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Equity and Quality of Global Chronic Kidney Disease Care: What Are We Waiting for?

Safety profile of sodium glucose co-transporter 2 (SGLT2) inhibitors: A brief summary

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