Protection of the kidney with sodium–glucose cotransporter 2 inhibitors: potential mechanisms raised by the large-scaled randomized control trials

  • Satoru KuriyamaEmail author
Review article


This communication provides a current overview on the renal protective effects of sodium–glucose cotransporter 2 (SGLT2) inhibitors in diabetics. Following the epoch-making publications, the CANVAS Program and the EMPA-REG OUTCOME trial, numerous literature has discussed the mechanisms by which SGLT2 inhibition exerts its cardio-renal protective effects. Some of them reached agreement, while others did not. This review focuses on the hemodynamic aspect and the remaining potential factors relevant to the renal protection which have not been so much taken up by other review papers. Questions unanswered include factors of uric acid, lipids, erythropoiesis and oxidative stress, salt and sympathetic nerve, and the Na–H exchanger in heart and kidney.


Sodium–glucose cotransporter 2 inhibitor Diabetic nephropathy Renal protection Uric acid Small dense LDL-cholesterol Erythropoiesis 


Compliance with ethical standards

Conflict of interest

No conflict of interest is declared.

Human and animal rights

This article does not contain any studies with human participants or animals performed by the authors.

Informed consent

There is no informed consent. This article is a review.


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Copyright information

© Japanese Society of Nephrology 2018

Authors and Affiliations

  1. 1.Miho Clinic, Jikei University School of MedicineTokyoJapan

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