PDF(Pubmed)
Abstract：
Chronic kidney disease (CKD) is a noncommunicable condition that has become a major healthcare burden across the globe, often underdiagnosed and associated with low awareness. The main cause that leads to the development of renal impairment is diabetes mellitus and, in contrast to other chronic complications such as retinopathy or neuropathy, it has been suggested that intensive glycemic control is not sufficient in preventing the development of diabetic kidney disease. Nevertheless, a novel class of antidiabetic agents, the sodium-glucose cotransporter-2 inhibitors (SGLT2i), have shown multiple renoprotective properties that range from metabolic and hemodynamic to direct renal effects, with a major impact on reducing the risk of occurrence and progression of CKD. Thus, this review aims to summarize current knowledge regarding the renoprotective mechanisms of SGLT2i and to offer a new perspective on this innovative class of antihyperglycemic drugs with proven pleiotropic beneficial effects that, after decades of no significant progress in the prevention and in delaying the decline of renal function, start a new era in the management of patients with CKD.
摘要：
慢性肾脏病（CKD）是一种非传染性疾病，已成为全球主要的医疗保健负担。通常诊断不足，并与低意识相关。导致肾功能损害发展的主要原因是糖尿病,与其他慢性并发症如视网膜病变或神经病变相反，有人认为强化血糖控制不足以预防糖尿病肾病的发生.然而，一类新型的抗糖尿病药物，钠-葡萄糖协同转运蛋白-2抑制剂（SGLT2i），已经显示出多种肾脏保护特性，从代谢和血液动力学到直接的肾脏作用，对降低CKD发生和进展的风险有重要影响。因此，这篇综述旨在总结当前有关SGLT2i的肾脏保护机制的知识，并为这种创新的抗高血糖药物提供新的视角，这些药物具有已证明的多效性有益作用，在预防和延缓肾功能下降方面数十年没有重大进展之后，开始CKD患者管理的新时代。
