SGLT2 Inhibitors for Primary and Secondary Protection from Cardiovascular and Renal Diseases in Type 2 Diabetes

Chronic kidney disease (CKD), often caused by diabetes, leads to kidney failure and increases cardiovascular disease (CVD) risk. Sodium-glucose co-transporter 2 inhibitors (SGLT2i), initially developed to reduce blood glucose by inhibiting renal glucose reabsorption, have shown promise in treating both CKD and CVD. Clinical trials reveal that SGLT2i reduce albuminuria, slow CKD progression, and decrease CVD events by enhancing renal glycosuria, natriuresis, and tubuloglomerular feedback. This results in improved kidney function and protection against glomerular hypertension and albuminuria. Key studies, like the CREDENCE trial, demonstrate the benefits of SGLT2i (e.g., canagliflozin) for patients with T2D and CKD, supporting their use for renal and cardiovascular protection. Although SGLT2i can cause side effects like ketoacidosis and infections, their positive impact on CKD progression and CVD prevention is significant. Ongoing research and strategic implementation are crucial for maximizing the therapeutic benefits of SGLT2i in CKD.