Advances in the mechanism of action of SGLT2 inhibitors on the kidney

Sodium-glucose co-transporter 2 (SLC5A2, SGLT2) inhibitors are a newly developed target drug for the inhibition of glucose reabsorption in nephric tubules in diabetic treatment. In addition to effectively reducing blood glucose in diabetic patients, SGLT 2 inhibitors have been found to have a lot of additional protective effects on the kidney and heart in recent studies(such as EMPA-REG OUTCOME, CANVAS, DECLARE-TIMI 58). In particular, a new study of canagliflozin for the improvement of kidney outcomes (CREDENCE) further confirms that SGLT2 inhibitors can reduce proteinuria progression and reduce the risk of renal endpoint events, with significant renal protection other than reducing blood glucose. However, the defined mechanisms of SGLTs inhibitors in improving renal prognosis are still unclear. This review will focus on the potential mechanisms of SGLT2 inhibitors (SGLT-2i) in the renal protection and rare adverse reactions of renal injury. Furthermore, the risk of renal injury resulting from these drugs and the focus points of future research are clarified in the article.