SGLT2i use in patients with diabetes and chronic kidney disease

Chronic kidney disease (CKD) is a progressive condition associated with significant mortality and morbidity. It is defined by decreased renal function (demonstrated by reduced estimated glomerular filtration rate (eGFR) and/or markers of kidney damage for at least three months). More than 1.8 million people in England have diagnosed CKD, the most common causes being diabetes, hypertension and glomerulonephritis. Kidney disease affects nearly 40% of all people with diabetes during their lifetime. Well known risk factors for progression of kidney disease include poor glycaemic control hypertension and albuminuria. There is substantial evidence that tight control of these risk factors can slow down the progression of kidney disease. In addition to this recent evidence shows that use of certain reno protective drugs can confer additional benefit and improve renal outcomes in patients with diabetes. Notably, these include drugs acting on the Renin Angiotensin Aldosterone System (RAAS) as sodium glucose transported 2 receptor inhibitors and Selective mineralocorticoid receptor antagonists.