Staff View: Use of sodium-glucose co-transporter-2 inhibitors in Asian patients with type 2 diabetes and kidney disease: An Asian perspective and expert recommendations

Use of sodium-glucose co-transporter-2 inhibitors in Asian patients with type 2 diabetes and kidney disease: An Asian perspective and expert recommendations

Early onset of type 2 diabetes and a high prevalence of co-morbidities predispose the Asian population to a high risk for, and rapid progression of, diabetic kidney disease (DKD). Apart from renin-angiotensin system inhibitors, sodium-glucose co-transporter-2 (SGLT-2) inhibitors have been shown to d...

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Main Authors:	Khoo, Chin Meng, Deerochanawong, Chaicharn, Chan, Siew Pheng, Matawaran, Bien, Sheu, Wayne Huey-Herng, Chan, Juliana, Mithal, Ambrish, Luk, Andrea, Suastika, Ketut, Yoon, Kun-Ho, Ji, Linong, Man, Nguyen Huu, Pollock, Carol
Format:	Article
Published:	Wiley 2021
Subjects:	R Medicine R Medicine (General)
Online Access:	http://eprints.um.edu.my/34528/
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spelling	my.um.eprints.345282022-09-14T08:21:07Z http://eprints.um.edu.my/34528/ Use of sodium-glucose co-transporter-2 inhibitors in Asian patients with type 2 diabetes and kidney disease: An Asian perspective and expert recommendations Khoo, Chin Meng Deerochanawong, Chaicharn Chan, Siew Pheng Matawaran, Bien Sheu, Wayne Huey-Herng Chan, Juliana Mithal, Ambrish Luk, Andrea Suastika, Ketut Yoon, Kun-Ho Ji, Linong Man, Nguyen Huu Pollock, Carol R Medicine R Medicine (General) Early onset of type 2 diabetes and a high prevalence of co-morbidities predispose the Asian population to a high risk for, and rapid progression of, diabetic kidney disease (DKD). Apart from renin-angiotensin system inhibitors, sodium-glucose co-transporter-2 (SGLT-2) inhibitors have been shown to delay renal disease progression in patients with DKD. In this review article, we consolidate the existing literature on SGLT-2 inhibitor use in Asian patients with DKD to establish contemporary guidance for clinicians. We extensively reviewed recommendations from international and regional guidelines, data from studies on Asian patients with DKD, global trials (DAPA-CKD, CREDENCE and DELIGHT) and cardiovascular outcomes trials. In patients with DKD, SGLT-2 inhibitor therapy significantly reduced albuminuria and the risk of hard renal outcomes (defined as the onset of end-stage kidney disease, substantial decline in renal function from baseline and renal death), cardiovascular outcomes and hospitalization for heart failure. In all the cardiovascular and renal outcomes trials, there was an initial decline in the estimated glomerular filtration rate (eGFR), which was followed by a slowing in the decline of renal function compared with that seen with placebo. Despite an attenuation in glucose-lowering efficacy in patients with low eGFR, there were sustained reductions in body weight and blood pressure, and an increase in haematocrit. Based on the available evidence, we conclude that SGLT-2 inhibitors represent an evidence-based therapeutic option for delaying the progression of renal disease in Asian patients with DKD and preserving renal function in patients at high risk of kidney disease. Wiley 2021-02 Article PeerReviewed Khoo, Chin Meng and Deerochanawong, Chaicharn and Chan, Siew Pheng and Matawaran, Bien and Sheu, Wayne Huey-Herng and Chan, Juliana and Mithal, Ambrish and Luk, Andrea and Suastika, Ketut and Yoon, Kun-Ho and Ji, Linong and Man, Nguyen Huu and Pollock, Carol (2021) Use of sodium-glucose co-transporter-2 inhibitors in Asian patients with type 2 diabetes and kidney disease: An Asian perspective and expert recommendations. Diabetes Obesity & Metabolism, 23 (2). pp. 299-317. ISSN 1462-8902, DOI https://doi.org/10.1111/dom.14251 <https://doi.org/10.1111/dom.14251>. 10.1111/dom.14251
institution	Universiti Malaya
building	UM Library
collection	Institutional Repository
continent	Asia
country	Malaysia
content_provider	Universiti Malaya
content_source	UM Research Repository
url_provider	http://eprints.um.edu.my/
topic	R Medicine R Medicine (General)
spellingShingle	R Medicine R Medicine (General) Khoo, Chin Meng Deerochanawong, Chaicharn Chan, Siew Pheng Matawaran, Bien Sheu, Wayne Huey-Herng Chan, Juliana Mithal, Ambrish Luk, Andrea Suastika, Ketut Yoon, Kun-Ho Ji, Linong Man, Nguyen Huu Pollock, Carol Use of sodium-glucose co-transporter-2 inhibitors in Asian patients with type 2 diabetes and kidney disease: An Asian perspective and expert recommendations
description	Early onset of type 2 diabetes and a high prevalence of co-morbidities predispose the Asian population to a high risk for, and rapid progression of, diabetic kidney disease (DKD). Apart from renin-angiotensin system inhibitors, sodium-glucose co-transporter-2 (SGLT-2) inhibitors have been shown to delay renal disease progression in patients with DKD. In this review article, we consolidate the existing literature on SGLT-2 inhibitor use in Asian patients with DKD to establish contemporary guidance for clinicians. We extensively reviewed recommendations from international and regional guidelines, data from studies on Asian patients with DKD, global trials (DAPA-CKD, CREDENCE and DELIGHT) and cardiovascular outcomes trials. In patients with DKD, SGLT-2 inhibitor therapy significantly reduced albuminuria and the risk of hard renal outcomes (defined as the onset of end-stage kidney disease, substantial decline in renal function from baseline and renal death), cardiovascular outcomes and hospitalization for heart failure. In all the cardiovascular and renal outcomes trials, there was an initial decline in the estimated glomerular filtration rate (eGFR), which was followed by a slowing in the decline of renal function compared with that seen with placebo. Despite an attenuation in glucose-lowering efficacy in patients with low eGFR, there were sustained reductions in body weight and blood pressure, and an increase in haematocrit. Based on the available evidence, we conclude that SGLT-2 inhibitors represent an evidence-based therapeutic option for delaying the progression of renal disease in Asian patients with DKD and preserving renal function in patients at high risk of kidney disease.
format	Article
author	Khoo, Chin Meng Deerochanawong, Chaicharn Chan, Siew Pheng Matawaran, Bien Sheu, Wayne Huey-Herng Chan, Juliana Mithal, Ambrish Luk, Andrea Suastika, Ketut Yoon, Kun-Ho Ji, Linong Man, Nguyen Huu Pollock, Carol
author_facet	Khoo, Chin Meng Deerochanawong, Chaicharn Chan, Siew Pheng Matawaran, Bien Sheu, Wayne Huey-Herng Chan, Juliana Mithal, Ambrish Luk, Andrea Suastika, Ketut Yoon, Kun-Ho Ji, Linong Man, Nguyen Huu Pollock, Carol
author_sort	Khoo, Chin Meng
title	Use of sodium-glucose co-transporter-2 inhibitors in Asian patients with type 2 diabetes and kidney disease: An Asian perspective and expert recommendations
title_short	Use of sodium-glucose co-transporter-2 inhibitors in Asian patients with type 2 diabetes and kidney disease: An Asian perspective and expert recommendations
title_full	Use of sodium-glucose co-transporter-2 inhibitors in Asian patients with type 2 diabetes and kidney disease: An Asian perspective and expert recommendations
title_fullStr	Use of sodium-glucose co-transporter-2 inhibitors in Asian patients with type 2 diabetes and kidney disease: An Asian perspective and expert recommendations
title_full_unstemmed	Use of sodium-glucose co-transporter-2 inhibitors in Asian patients with type 2 diabetes and kidney disease: An Asian perspective and expert recommendations
title_sort	use of sodium-glucose co-transporter-2 inhibitors in asian patients with type 2 diabetes and kidney disease: an asian perspective and expert recommendations
publisher	Wiley
publishDate	2021
url	http://eprints.um.edu.my/34528/
_version_	1744649184757153792
score	13.211869

Use of sodium-glucose co-transporter-2 inhibitors in Asian patients with type 2 diabetes and kidney disease: An Asian perspective and expert recommendations

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