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Sodium-glucose cotransporter-2 inhibitor for renal function preservation in patients with type 2 diabetes mellitus: A Korean Diabetes Association and Korean Society of Nephrology consensus statement

Kidney Research and Clinical Practice 2020년 39권 3호 p.269 ~ 283
오태정, 문주영, 허규연, 고승현, 김현정, 김태희, 이동원, 문민경,
소속 상세정보
오태정 ( Oh Tae-Jung ) - Seoul National University College of Medicine Department of Internal Medicine
문주영 ( Moon Ju-Young ) - Kyung Hee University School of Medicine Department of Internal Medicine
허규연 ( Hur Kyu-Yeon ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Medicine
고승현 ( Ko Seung-Hyun ) - Catholic University College of Medicine St. Vincent’s Hospital Department of Internal Medicine
김현정 ( Kim Hyun-Jung ) - Korea University College of Medicine Department of Preventive Medicine
김태희 ( Kim Tae-Hee ) - Inje University College of Medicine Inje University Busan Paik Hospital Department of Internal Medicine
이동원 ( Lee Dong-Won ) - Pusan National University School of Medicine Department of Internal Medicine
문민경 ( Moon Min-Kyong ) - Seoul National University College of Medicine Department of Internal Medicine

Abstract


Diabetes is a leading cause of end-stage renal disease. Therefore, prevention of renal dysfunction is an important treatment goal in the management of diabetes. The data of landmark cardiovascular outcome trials of sodiumglucose cotransporter-2 (SGLT2) inhibitors showed profound reno-protective effects. The Korean Diabetes Association and the Korean Society of Nephrology reviewed clinical trials and performed a meta-analysis to assess the effects of SGLT2 inhibitors on the preservation of estimated glomerular filtration rate (eGFR). We limited the data of SGLT2 inhibitors which can be prescribed in Korea. Both eGFR value and its change from the baseline were significantly more preserved in the SGLT2-inhibitor treatment group compared to the control group after 156 weeks. However, some known adverse events were increased in SGLT2 inhibitor treatment, such as genital infection, diabetic ketoacidosis, and volume depletion. We recommend long-term use of SGLT2 inhibitors in patients with type 2 diabetes mellitus (T2DM) for attenuation of renal function decline. However, we cannot generalize our recommendations due to the lack of long-term clinical trials testing the reno-protective effects of every SGLT2 inhibitor in a broad range of patients with T2DM. This recommendation can be revised and updated after the publication of several large-scale renal outcome trials.

키워드

Diabetes mellitus, type 2; Glomerular filtration rate; Renal function; Sodium-glucose transporter-2 inhibitors

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