SGLT2 inhibitors (gliflozins) were developed as oral antidiabetics. They enhance urinary glucose excretion by inhibiting SGLT-2 (sodium-dependent glucose co-transporter-2) in the renal tubuli. The discovery of kidney benefits beyond the lowering of blood sugar has been made by Professor Christoph Wanner from Germany: The EMPA-REG OUTCOME study initially showed that the rate of cardiovascular events in type 2 diabetic pa-tients is significantly reduced if the SGLT2 inhibitor empagliflozin is administered. Kidney function in diabetics who already had diabetic nephropathy was also found to benefit sig-nificantly from the treatment (as an incidental finding, so to speak). In other cardio-vascular outcome studies, this effect has been confirmed for other SGLT2 inhibitors in type 2 diabetics with diabetic nephropathy (albuminuria). The DAPA-CKD study showed that, even in non-diabetic CKD patients, i.e., in patients with other under-lying causes of kidney disease, the combined renal endpoint (loss of renal function ~50%, dialysis requirement or mortality) is significantly delayed by SGLT2 inhibition with dapagliflozin (HR 0.61).
