Blood pressure lowering slows the progression of diabetic nephropathy whereas the effects of glycaemic control are smaller and slower. New findings from the EMA-REG OUTCOME investigators indicate that SGLT2 inhibition slows the progression of kidney disease by lowering glucose and blood pressure, thereby lowering the risk of adverse renal outcomes in this patient group.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$209.00 per year
only $17.42 per issue
Rent or buy this article
Prices vary by article type
from$1.95
to$39.95
Prices may be subject to local taxes which are calculated during checkout
References
Tonelli, M. et al. Risk of coronary events in people with chronic kidney disease compared with those with diabetes: a population-level cohort study. Lancet 380, 807–814 (2012).
Saran, R. et al. US Renal Data System 2015 Annual Data Report: epidemiology of kidney disease in the United States. Am. J. Kidney Dis. 67, A7–A8 (2016).
Wanner, C. et al. Empagliflozin and progression of kidney disease in type 2 diabetes. N. Engl. J. Med. http://dx.doi.org/10.1056/NEJMoa1515920 (2016).
Kalaitzidis, R. & Bakris, G. L. in Handbook of Chronic Kidney Disease Management (ed Daugirdas, J.) 224–239 (Lippincott, 2011).
Zoungas, S. et al. Follow-up of blood-pressure lowering and glucose control in type 2 diabetes. N. Engl. J. Med. 371, 1392–1406 (2014).
Zinman, B. et al. Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. N. Engl. J. Med. 373, 2117–2128 (2015).
Cherney, D. Z. et al. Renal hemodynamic effect of sodium-glucose cotransporter 2 inhibition in patients with type 1 diabetes mellitus. Circulation 129, 587–597 (2014).
Tikkanen, I. et al. Empagliflozin reduces blood pressure in patients with type 2 diabetes and hypertension. Diabetes Care 38, 420–428 (2015).
Oliva, R. V. & Bakris, G. L. Blood pressure effects of sodium-glucose co-transport 2 (SGLT2) inhibitors. J. Am. Soc. Hypertens. 8, 330–339 (2014).
Rafiq, K. et al. Role of the renal sympathetic nerve in renal glucose metabolism during the development of type 2 diabetes in rats. Diabetologia 58, 2885–2898 (2015).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
G.L.B. has consulted for Bayer, Boehringer-Ingelheim, Takeda, AbbVie, Janssen, Merck, Astra-Zeneca and Relypsa. H.Y. declares no competing interests.
PowerPoint slides
Rights and permissions
About this article
Cite this article
Yamout, H., Bakris, G. SGLT2 inhibitors might halt progression of diabetic nephropathy. Nat Rev Nephrol 12, 583–584 (2016). https://doi.org/10.1038/nrneph.2016.109
Published:
Issue Date:
DOI: https://doi.org/10.1038/nrneph.2016.109