Educational Symposium

Move Over and Make Room for SGLT2 Inhibitors in CKD

November 09, 2019 | 12:45 PM - 01:45 PM

Location: Independence Ballroom, Marriott Marquis

Session Description

Sodium glucose cotransporter 2 (SGLT2) inhibitors lower blood glucose by increasing glycosuria. These agents are believed to have direct effects in protecting the kidney by reducing glomerular hyperfiltration through increasing delivery of sodium chloride to the macula densa with restoration of tubuloglomerular feedback. SGLT2 inhibitors also may reduce CKD risk by lowering blood glucose, blood pressure, and body weight.

Early results from cardiovascular outcome trials of SGLT2 inhibitors pointed to kidney survival benefits as secondary outcomes. The CREDENCE clinical trial is the first to report substantially reduced risk (~30%) for a primary outcome of loss of kidney function, ESKD, and death due to kidney or cardiovascular diseases by canagliflozin treatment in patients with type 2 diabetes and CKD. These improved outcomes were accomplished on a background of treatment with ACE inhibitors or ARBs.

Questions remain regarding which patients with CKD are most likely to benefit from SGLT2 inhibition (e.g., with or without diabetes, with or without albuminuria) and whether benefits persist across CKD stages. This symposium discusses a mechanistic basis for SGLT2 inhibition, the current evidence for enhanced kidney and patient survival, and future directions for CKD treatment.

Support is provided by an educational grant from Janssen Biotech, Inc., administered by Janssen Scientific Affairs, LLC.

Learning Objective(s)

  • Describe mechanisms and clinical principles underlying the effects of SGLT2 inhibition on the kidney
  • Discuss the strengths and limitations of SGLT2 inhibition for the treatment of patients with diabetes and CKD

Learning Pathway(s)

  • Chronic Kidney Disease

Moderator

  • Julie R. Ingelfinger, MD

Presentations

  • Introduction
    12:45 PM - 12:55 PM
    Julie R. Ingelfinger, MD
  • What We Know About SGLT2 Inhibition and the Kidneys
    12:55 PM - 01:15 PM
    Hiddo Jan L Heerspink, PhD
  • Clinical Implications and Next Steps for SGLT2 Inhibition in CKD
    01:15 PM - 01:35 PM
    David Cherney, MD, PhD
  • Questions and Answers
    01:35 PM - 01:45 PM