Article (Scientific journals)
Effects of reducing blood pressure on renal outcomes in patients with type 2 diabetes: Focus on SGLT2 inhibitors and EMPA-REG OUTCOME.
Scheen, André; DELANAYE, Pierre
2017In Diabetes and Metabolism, (epub ahead of print)
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Keywords :
Blood pressure; Empagliflozin; Hypertension; Kidney; SGLT2 inhibitor; Type 2 diabetes
Abstract :
[en] Empagliflozin, a sodium-glucose cotransporter type 2 (SGLT2) inhibitor, has enabled remarkable reductions in cardiovascular and all-cause mortality as well as in renal outcomes in patients with type 2 diabetes (T2D) and a history of cardiovascular disease in the EMPA-REG OUTCOME. These results have been attributed to haemodynamic rather than metabolic effects, in part due to the osmotic/diuretic action of empagliflozin and the reduction in arterial blood pressure (BP). The present narrative review includes the results of meta-analyses of trials evaluating the effects on renal outcomes of lowering BP in patients with T2D, with a special focus on the influence of baseline and achieved systolic BP, and compares the renal outcome results of the EMPA-REG OUTCOME with those of other major trials with inhibitors of the renin-angiotensin system in patients with T2D and the preliminary findings with other SGLT2 inhibitors, and also evaluates post hoc analyses from the EMPA-REG OUTCOME of special interest as regards the BP-lowering hypothesis and renal function. While systemic BP reduction associated to empagliflozin therapy may have contributed to the renal benefits reported in EMPA-REG OUTCOME, other local mechanisms related to kidney homoeostasis most probably also played a role in the overall protection observed in the trial.
Disciplines :
Endocrinology, metabolism & nutrition
Pharmacy, pharmacology & toxicology
Cardiovascular & respiratory systems
Author, co-author :
Scheen, André  ;  Université de Liège > Département des sciences cliniques > Département des sciences cliniques
DELANAYE, Pierre  ;  Centre Hospitalier Universitaire de Liège - CHU > Department of Medicine > Division of Nephrology, Dialysis, Transplantation and Hypertension
Language :
English
Title :
Effects of reducing blood pressure on renal outcomes in patients with type 2 diabetes: Focus on SGLT2 inhibitors and EMPA-REG OUTCOME.
Publication date :
2017
Journal title :
Diabetes and Metabolism
ISSN :
1262-3636
eISSN :
1878-1780
Publisher :
Elsevier Masson, Paris, France
Issue :
epub ahead of print
Peer reviewed :
Peer Reviewed verified by ORBi
Commentary :
Copyright (c) 2017. Published by Elsevier Masson SAS.
Available on ORBi :
since 24 March 2017

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