SGLT2 Inhibitors In CKD

Type 2 diabetes, which is becoming more common across the world, is a leading cause of Chronic Kidney Diseases and renal failure. In a broad clinical test of persons with type 2 diabetes, sodium glucose transport protein 2 inhibitors (SGLT2i) dramatically decreased the development of CKD, severe adverse cardiovascular occurrences and heart failure. In this article, we will discuss how we can initiate an SGLT2i in individuals with type 2 diabetes and CKD.

What are SGLT2 Inhibitors?

Inhibitors of the sodium-glucose transport protein 2 (SGLT2) are a kind of drug utilized for treatment of type 2 diabetes. Gliflozins are another name for them.


SGLT2 inhibitors restrict glucose from being reabsorbed from blood that has been filtered by your kidneys, allowing for easier glucose discharge in the urine. This assists in lowering blood sugar levels.


Continue reading to discover more about the various types of SGLT2 inhibitors, as well as the possible advantages and hazards of using them in your therapeutic approach.

What are the different types of SGLT2 inhibitors?

To date, the U.S. The FDA has authorized four kinds of SGLT2 inhibitors for the treatment of type 2 diabetes:

  1. Invokana (canagliflozin): In people with type 2 diabetes, Invokana can assist with the following:
  • Improved blood sugar control.
  • In people with type 2 diabetes and cardiovascular disease, decrease the risk of serious cardiovascular problems.
  • In people with type 2 diabetes and diabetic nephropathy, minimize the risk of renal disease, cardiovascular mortality, and heart failure hospitalization.
  1. Farxiga (dapagliflozin) is a drug that is used to treat type 2 diabetes and heart failure. It is capable of the following:
  • Improved blood sugar control.
  • Decrease the likelihood of heart failure hospitalization in persons with type 2 diabetes and cardiovascular disease.
  • Lower the risk of heart failure-related mortality and hospitalization in people with a low ejection fraction.
  • Decrease the risk of renal disease developing further and delay the course of kidney disease to end-stage kidney disease.
  1. Jardiance (empagliflozin): Jardiance can be utilized to assist persons with type 2 diabetes accomplish the following goals:
  • Improved blood sugar control.
  • In people with type 2 diabetes and cardiovascular disease, lower the risk of cardiovascular mortality.
  1. Steglatro (ertugliflozin): Steglatro (ertugliflozin) is a blood sugar control drug for individuals with type 2 diabetes.


If you suffer from type 2 diabetes, an SGLT2 inhibitor may be taken alongside other diabetic medications such as metformin.

SGLT2 inhibitors are compared.

SGLT2 inhibitor

FDA approval



Invokana (canagliflozin)


Type 2 diabetes

100 – 300 mg daily

Farxiga (dapagliflozin)


Type 2 diabetes Heart failure

5–10 mg daily for type 2 diabetes 10 mg daily for heart failure

Jardiance (empagliflozin)


Type 2 diabetes

10 – 25 mg daily

Steglatro (ertugliflozin)


Type 2 diabetes

5 – 15 mg daily

What are the dangers and adverse effects of using an SGLT2 inhibitor?

Inhibitors of SGLT2 are usually thought to be safe. However, they might have negative adverse effects in rare circumstances. Receiving this sort of drug, for example, may increase your chance of developing:

  • Infections of the urinary tract (UTIs)
  • Infections caused by yeast
  • Diabetic ketoacidosis is a condition in which your blood becomes acidic.
  • Hypoglycemia, or low blood sugar, is a condition in which the blood sugar level is abnormally low.
  • Hypotension, or low blood pressure, is a condition in which the blood pressure is abnormally low.


When using SGLT2 inhibitors, more significant adverse effects might develop in rare cases:

  • In persons who use SGLT2 inhibitors, a dangerous kind of genital infection has been reported Trusted Source. Necrotizing fasciitis, often known as Fournier’s gangrene, is a form of infection.
  • Invokana (canagliflozin) may also raise the chance of bone injuries, according to certain studies. Other SGLT2 inhibitors have not been connected to these side effects.
  • When using SGLT2 inhibitors, some people may develop renal damage or have decreased kidney functioning.
  • Although the data is conflicting, some study suggests that Invokana (canagliflozin) is linked to a higher incidence of lower limb amputation.


In brief, euglycemic ketoacidosis, volume depletion and genital mycotic infections are all serious side effects of SGLT2 inhibitors. The balance of advantages and hazards of SGLT2 inhibitors, as well as risk mitigation methods, should be carefully considered. To ensure broad usage of these life-saving drugs, effective implementation tactics are required.


More information about the hazards of using SGLT2 inhibitors may be obtained from your doctor. They can also assist you in recognising and managing any potential adverse effects.

Practical Provider Guide to Initiating SGLT2 Inhibitors in patients with type 2 diabetes and CKD.

The Advantages of SGLT2 Inhibitors

SGLT2 inhibitors are considered to enhance glomerular hemodynamic function and other local and systemic processes implicated in the pathophysiology of CKD and CVD. People with T2DM should utilize SGLT2 inhibitors whenever possible to minimize their risk of CKD and CVD, according to clinical study admission criteria.

What is the dosage of SGLT2 inhibitors?

SGLT2 inhibitors are drugs that are taken orally. They can be taken as pills. If your doctor prescribes an SGLT2 inhibitor as part of your medication, you’ll usually be told to take it once a day.


Your doctor may give an SGLT2 inhibitor in addition to other diabetic drugs in some situations. This kind of drug, for example, can be used with metformin..

Is it okay to take SGLT2 inhibitors with other medications?

When adding a new medicine to your treatment plan, think about how it can interact with other medications you’re taking.


If you’re already on other diabetic drugs to control your blood sugar, adding an SGLT2 inhibitor raises your chance of low blood sugar.


Furthermore, SGLT2 inhibitors might boost the action of certain types of diuretics, leading you to urinate more often. Dehydration and low blood pressure can occur as a result of this.


Before starting a new drug or supplement, check with your doctor to see if it will interfere with anything else you’re taking. To reduce the chance of harmful medication effects, your doctor may make adjustments to your recommended treatment.

Final Words

SGLT2 inhibitors are used to help persons with type 2 diabetes and CKD regulate their blood sugar.


This type of drug has been discovered to provide advantages for heart failure, other cardiovascular disorders, and chronic renal disease, in addition to lowering blood sugar levels.


SGLT2 inhibitors can have adverse effects or interact negatively with specific medications, despite the fact that they are generally regarded as safe. More information about the possible advantages and hazards of including this sort of drug in your therapeutic plan can be obtained from your doctor.

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