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Lower blood pressure enhances SGLT2 renoprotection

By Colin Kenny, Editor – Diabetes Distilled

Researchers wanted to understand the relationship between the renoprotective effects of sodium-glucose cotransporter-2 (SGLT2) inhibitors and blood pressure (BP) in patients with low BP. They examined BP and urinary albumin:creatinine ratio data from patients with type 2 diabetes and chronic kidney disease before and after treatment. Lower BP was found to be associated with greater change in urinary albumin:creatinine ratio following treatment with SGLT2 inhibitors. The researchers concluded that stricter BP management is required to enhance the renoprotective effects of SGLT2 inhibitors.

BP control is important in the management of people with diabetes, particularly those with chronic kidney disease. Japanese investigators performed a retrospective study on 740 patients to investigate the renal effects of SGLT2 inhibitors in patients with low BP and determine the overall effects of BP management on the clinical outcomes of treatment. Patients were split into two groups based on their BP management status at the time SGLT2 inhibitor treatment was started. There were 327 patients with well controlled BP (<130/80 mmHg) and 413 with poorly controlled BP (systolic BP >130 mmHg or diastolic BP >80 mmHg). 
When the two groups were compared following treatment, the well-controlled BP group had a greater reduction in albumin:creatine ratio than the poorly controlled BP group. This finding confirms that BP management status after SGLT2 inhibitor administration influences the extent of urinary albumin:creatinine ratio change.

Stricter BP management might be needed in general practice to enhance the renoprotective effects of SGLT2 inhibitors in type 2 diabetes patients with chronic kidney disease. 

To access the publication, click here

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