Abstract

MORALES-OLVERA, D et al. iSGLT2 and its potential nephroprotector effect in patients with diabetes mellitus 2. Med. interna Méx. [online]. 2017, vol.33, n.4, pp.503-510. ISSN 0186-4866.

Type 2 diabetes mellitus 2 (DM2) is already a worldwide epidemic, in addition, diabetic nephropathy has become the leading cause of end-stage renal failure. In patients with DM2 there is an increased expression of the sodium-glucose cotransporters 2 (SGLT2) that contribute to the maintenance of hyperglycemia. Therefore, the inhibitors of this transporter represent an innovative therapy independent of the action of insulin or the function of pancreatic beta cells. Recent studies have shown that iSGLT2 have beneficial effects on microvasculature, especially in the progression of diabetic nephropathy. This effect is due not only to improved glycemic control but also to direct effects on the kidney. iSGLT2 induce glycosuria to reverse renal glucotoxicity. In experimental studies it has been observed that, in addition, hyper-filtration as well as inflammatory and fibrotic markers are reduced. There has also been a reduction in effective circulating volume and an increase in the activity of circulating renin-angiotensin-aldosterone system blockers (RAA blockers), thus creating a nephroprotective effect.

Keywords : type 2 diabetes mellitus; diabetic nephropathy; glomerular hyperfiltration; SGLT2 inhibitors; glucose toxicity; nephroprotection; EMPA-REG OUTCOME.

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