Sodium Glucose Cotransporter-2 Inhibition and Renal Function
Abstract
Sodium glucose cotransporter-2 inhibitors (SGLT2i) are approved therapies for renal decline in type 2 diabetes (T2D). Yet there is limited evidence on SGLT2i impact outside of T2D, which this thesis addresses. We hypothesized that 1) the SGLT2i empagliflozin would mediate intrarenal function in type 1 diabetes (T1D), 2) the SGLT2i canagliflozin would be tolerated in renal transplant populations and 3) the SGLT2i dapagliflozin would be protective in focal segmental glomerulosclerosis (FSGS), a subtype of non-diabetic renal disease. In the first study, we found intrarenal mediation upon SGLT2i therapy in T1D. In the second study, SGLT2i were tolerated in kidney transplant recipients. In the third study, SGLT2i imparted insignificant renoprotection in FSGS. Thus, despite the potential of SGLT2i as a renoprotective therapy outside of T2D, its efficacy may vary across disease subtypes, due to renal SGLT2 regulation. Larger clinical trials are needed to further characterize the renal impact of SGLT2i.
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