Possible renoprotective mechanisms of SGLT2 inhibitors
Treatment with a sodium glucose cotransporter 2 (SGLT2) inhibitor in patients with chronic kidney disease reduces the renal risk independent of changes in blood glucose concentrations and blood pressure. However, the precise mechanism responsible for this SGLT2 inhibitor-induced renoprotective effec...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-03-01
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| Series: | Frontiers in Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2023.1115413/full |
| _version_ | 1827996597843132416 |
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| author | Akira Nishiyama Kento Kitada |
| author_facet | Akira Nishiyama Kento Kitada |
| author_sort | Akira Nishiyama |
| collection | DOAJ |
| description | Treatment with a sodium glucose cotransporter 2 (SGLT2) inhibitor in patients with chronic kidney disease reduces the renal risk independent of changes in blood glucose concentrations and blood pressure. However, the precise mechanism responsible for this SGLT2 inhibitor-induced renoprotective effect is unclear. We have previously shown that SGLT2 inhibitors induce antihypertensive effects with decreased sympathetic nerve activity, which is associated with transient natriuresis. Furthermore, treatment with an SGLT2 inhibitor improves renal ischemia by producing vascular endothelial growth factor-a in the renal tubules. Other studies have suggested that ketone body production, changes in glomerular hemodynamics, and intrarenal metabolic changes and a reduction in oxidative stress due to decreased tubulointerstitial glucose levels may also be involved in the renoprotective effects of SGLT2 inhibitors. In this review, we summarize the mechanism responsible for the SGLT2 inhibitor-induced renoprotective effects, including our recent hypothesis regarding an “aestivation-like response,” which is a biological defense response to starvation. |
| first_indexed | 2024-04-10T05:13:20Z |
| format | Article |
| id | doaj.art-0322468870804413961df3422c7ab812 |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-04-10T05:13:20Z |
| publishDate | 2023-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-0322468870804413961df3422c7ab8122023-03-09T04:42:28ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2023-03-011010.3389/fmed.2023.11154131115413Possible renoprotective mechanisms of SGLT2 inhibitorsAkira NishiyamaKento KitadaTreatment with a sodium glucose cotransporter 2 (SGLT2) inhibitor in patients with chronic kidney disease reduces the renal risk independent of changes in blood glucose concentrations and blood pressure. However, the precise mechanism responsible for this SGLT2 inhibitor-induced renoprotective effect is unclear. We have previously shown that SGLT2 inhibitors induce antihypertensive effects with decreased sympathetic nerve activity, which is associated with transient natriuresis. Furthermore, treatment with an SGLT2 inhibitor improves renal ischemia by producing vascular endothelial growth factor-a in the renal tubules. Other studies have suggested that ketone body production, changes in glomerular hemodynamics, and intrarenal metabolic changes and a reduction in oxidative stress due to decreased tubulointerstitial glucose levels may also be involved in the renoprotective effects of SGLT2 inhibitors. In this review, we summarize the mechanism responsible for the SGLT2 inhibitor-induced renoprotective effects, including our recent hypothesis regarding an “aestivation-like response,” which is a biological defense response to starvation.https://www.frontiersin.org/articles/10.3389/fmed.2023.1115413/fullSGLT2 inhibitorchronic kidney disease (CKD)diabetic kidney disease (DKD)renal functionmetabolismaestivation-like response |
| spellingShingle | Akira Nishiyama Kento Kitada Possible renoprotective mechanisms of SGLT2 inhibitors Frontiers in Medicine SGLT2 inhibitor chronic kidney disease (CKD) diabetic kidney disease (DKD) renal function metabolism aestivation-like response |
| title | Possible renoprotective mechanisms of SGLT2 inhibitors |
| title_full | Possible renoprotective mechanisms of SGLT2 inhibitors |
| title_fullStr | Possible renoprotective mechanisms of SGLT2 inhibitors |
| title_full_unstemmed | Possible renoprotective mechanisms of SGLT2 inhibitors |
| title_short | Possible renoprotective mechanisms of SGLT2 inhibitors |
| title_sort | possible renoprotective mechanisms of sglt2 inhibitors |
| topic | SGLT2 inhibitor chronic kidney disease (CKD) diabetic kidney disease (DKD) renal function metabolism aestivation-like response |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2023.1115413/full |
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