The emerging landscape of SGLT2 inhibitors in pediatric populations with kidney diseases: A comprehensive literature review

• Main Author: Freitas,Joana
• Publication Date: 2024
• Other Authors: Machado,Sara, Vieira,Beatriz, Monteiro,Sara, Faria,Sameiro, Costa,Teresa, Mota,Conceição
• Format: Article
• Language: eng
• Source: Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
• Download full: http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-07542024000200111
• topic: cardiovascular disease; chronic kidney disease; diabetes mellitus; gliflozin; pediatrics; sodium-glucose co-transporter 2 inhibitor

Abstract Sodium-glucose cotransporter 2 inhibitors (SGLT2i), originally developed as innovative antihyperglycemic agents, have demonstrated significant benefits in improving metabolic markers and protecting the kidneys and heart in patients with or without type 2 diabetes mellitus. The mechanisms behind these unexpected cardiorenal benefits cannot be attributed solely to improved glycemic control. Recent data suggest that metabolic reprogramming plays a role in the development of cardiorenal metabolic disease. Despite the effectiveness of SGLT2i in the management of chronic kidney disease (CKD)-related comorbidities in adults, their use in the pediatric population remains to be validated. The challenge in pediatric CKD lies in the imbalance between the metabolic needs of a growing child and the declining functional capacity of a failing kidney. Developing strategies to address modifiable factors in the progression of kidney disease is critical given the extended lifespan of the pediatric population. SGLT2i have emerged as innovative candidates for the treatment of CKD in children. By improving renal hemodynamic adaptation and mitigating overall CKD complications, these agents have the potential to be a novel therapeutic option for pediatric patients. This review will focus on the current understanding of how SGLT2i may provide cardiorenal protection.