Sodium-glucose cotransporter-2 inhibitors (SGLT2 inhibitors) were originally developed as antidiabetic agents, with cardiovascular (CV) outcome trials demonstrating improved CV outcomes in patients with type 2 diabetes mellitus (T2D). Secondary analyses of CV outcome trials and later dedicated kidney outcome trials consistently reported improved kidney-related outcomes independent of T2D status and across a range of kidney function and albuminuria. Importantly, SGLT2 inhibitors are generally safe and well tolerated, with clinical trials and real-world analyses demonstrating a decrease in the risk of acute kidney injury. The kidney protective effects of SGLT2 inhibitors generally extend across different members of the class, possibly on the basis of hemodynamic, metabolic, anti-inflammatory, and antifibrotic mechanisms. In this review, we summarize the effects of SGLT2 inhibitors on kidney outcomes in diverse patient populations.

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SGLT2 抑制剂：肾脏的甜蜜成功

钠-葡萄糖协同转运蛋白 2 抑制剂（SGLT2 抑制剂）最初是作为抗糖尿病药物开发的，心血管 (CV) 结局试验表明可改善 2 型糖尿病 (T2D) 患者的 CV 结局。 CV 结果试验和后来专门的肾脏结果试验的二次分析一致报告，肾脏相关结果得到改善，与 T2D 状态无关，并且涵盖一系列肾功能和蛋白尿。重要的是，SGLT2 抑制剂通常是安全的且耐受性良好，临床试验和现实世界分析表明急性肾损伤的风险降低。 SGLT2 抑制剂的肾脏保护作用通常涵盖该类别的不同成员，可能基于血流动力学、代谢、抗炎和抗纤维化机制。在这篇综述中，我们总结了 SGLT2 抑制剂对不同患者群体肾脏结局的影响。