Optimización SGLT2 para cardionefro protección
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ene 14, 2025
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https://doi.org/10.36677/medicinainvestigacion.v13i1.24227
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Los inhibidores del cotransportador de sodio-glucosa tipo 2 (SGLT2) no solo regulan los niveles de glucosa en la diabetes tipo 2, sino que también ofrecen protección renal y cardiovascular. Contribuyen a la reducción de eventos cardiovasculares y la progresión de enfermedades renales al disminuir la presión arterial, la carga de glucosa y el estrés oxidativo, además de mejorar la función cardiaca. Estos beneficios los posicionan como herramientas cruciales en el manejo integral de enfermedades metabólicas y cardiovasculares.
El propósito de esta revisión es explorar los beneficios del uso de inhibidores del cotransportador de sodio-glucosa como medidas de cardioprotección y nefroprotección, por lo que se realizó una revisión de 30 fuentes bibliograficas, desde el año 2020 hasta el año 2023 donde se enfatizara la importancia de los mismos.
Los inhibidores SGLT2 desempeñan un papel fundamental en el control glucémico de pacientes diabéticos, integrándose en el grupo de terapias orales hipoglucemiantes emergentes. No obstante, su relevancia se destaca aún más por su efecto beneficioso como protectores renales y cardiovasculares, incluso en pacientes no diabéticos con algún grado de afectación en estos órganos. Estos fármacos demuestran efectos significativos no solo en la reducción de síntomas, sino también en la disminución de marcadores bioquímicos, la progresión de la enfermedad y la morbimortalidad; por ello la importancia de considerarlos en la practica diaria tanto de paciente diabeticos como no diabeticos.
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YAMASAKI RAMOS, Yukiko Harumi; HADDAD TOLEDO, Marbella.
Optimización SGLT2 para cardionefro protección.
Medicina e Investigación Universidad Autónoma del Estado de México, [S.l.], v. 13, n. 1, p. 174-182, ene. 2025.
ISSN 2594-0600.
Disponible en: <https://medicinainvestigacion.uaemex.mx/article/view/24227>. Fecha de acceso: 18 ago. 2026
doi: https://doi.org/10.36677/medicinainvestigacion.v13i1.24227.
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Esta obra está bajo licencia internacional Creative Commons Reconocimiento-NoComercial-SinObrasDerivadas 4.0.
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1. Hiraizumi, M., Akashi, T., Murasaki, K. et al. Transport and inhibition mechanism of the human SGLT2–MAP17 glucose transporter. Nat Struct Mol Biol 31, 159–169 (2024). https://doi.org/10.1038/s41594-023-01134-0
2. Han, L., Qu, Q., Aydin, D. et al. Structure and mechanism of the SGLT family of glucose transporters. Nature.601, 274–279 (2022). https://doi.org/10.1038/s41586-021-04211-w
3. Yoshifumi S. SGLT2 Inhibitors: The Star in the Treatment of Type 2 Diabetes?. Diseases 2020, 8, 14; doi:10.3390/diseases8020014
4. Merlin T, Brendon N, Stephen T et al. SGLT2 inhibitors for patients with type 2 diabetes and CKD: a narrative review. Endocrine Connections 2023. 12,;e230005. https://doi.org/10.1530/EC-23-0005
5. Nelinson D, Sosa J, Chilton R. SGLT2 inhibitors: a narrative review of efficacy and safety J Osteopath Med 2021; 121(2): 229–239. https://doi.org/10.1515/jom-2020-0153
6. Yuwen C, Xin L, Gaosi X. Combination therapy with SGLT2 inhibitors for diabetic kidney disease. Biomedicine & Pharmacotherapy ELSEVIER 2020; 127:1-12. https://doi.org/10.1016/j.biopha.2020.110192
7. Eveline P, Louis H, Majon M et al. Diuretics, SGLT2 inhibitors and falls in older heart failure patients: to prescribe or to deprescribe? A clinical review. European Geriatric Medicine 2023. 14:659–674 https://doi.org/10.1007/s41999-023-00752-7
8. Neal B, Perkovic V, Mahaffey KW, et al. Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes. N Engl J Med. 2017;377(7):644-657. doi: 10.1056/NEJMoa1611925.
9. Zinman B, Wanner C, Lachin JM, et al. Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes. N Engl J Med. 2015;373(22):2117-28. doi: 10.1056/NEJMoa1504720.
10. Suzuki Y, Kaneko K, Okadaet A et al. Comparison of cardiovascular outcomes between SGLT2 inhibitors in diabetes mellitus. Cardiovascular Diabetology. 2022;21:67 https://doi.org/10.1186/s12933-022-01508-6
11. Pardeep S, John J, McMurray M. Efficacy of Dapagliflozin on Renal Function and Outcomes in Patients With Heart Failure With Reduced Ejection Fraction. Circulation 2021. 2021;143:298–309. DOI: 10.1161/CIRCULATIONAHA.120.050391
12. Wiviott SD, Raz I, Bonaca MP, et al. Dapagliflozin and Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med. 2019;380(4):347-357.
13. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes. Diabetes Care 2024;47(Suppl. 1):S179–S218 | https://doi.org/10.2337/dc24-S010
14. Packer M, Anker S, Butler J et al. Cardiovascular and Renal Outcomes with Empagliflozin in Heart Failure N Engl J Med 2020;383:1413-1424. DOI: 10.1056/NEJMoa20221
15. ESC Guidelines for the management of cardiovascular disease in patients with diabetes. 2023 ESC Clinical Practice Guidelines. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/CVD-and-Diabetes-Guidelines
16. Dharia A, Khan A, Vikas S et al. SGLT2 Inhibitors: The Sweet Success for Kidneys. Annu. Rev. Med. 2023. 74:369–84. https://doi.org/10.1146/annurev-med-042921- 102135
17. Nishiyama A, Kento K. Possible renoprotective mechanisms of SGLT2 inhibitors. Front Med 2023. 10:1115413. doi: 10.3389/fmed.2023.1115413
18. Podestà M; Sabiu G, Galassi A et al. SGLT2 Inhibitors in Diabetic and Non-Diabetic Chronic Kidney Disease. Biomedicines 2023, 11, 279. https://doi.org/10.3390/ biomedicines11020279
19. Yau K, Dharia A, Alrowiyti, I et al. Prescribing SGLT2 inhibitors in patients with CKD: Expanding indications and practical considerations. Kidney International Reports 2022; 7(7), 1463–1476. https://doi.org/10.1016/j.ekir.2022.04.094
20. Heerspink H, Stefánsson BV, Correa-Rotter R, et al. Dapagliflozin in patients with chronic kidney disease. N Engl J Med 2020; 15: 1436–1446.
21. Chen TK, Knicely DH, Grams ME. Chronic Kidney Disease Diagnosis and Management: A Review. JAMA. 2019;322(13):1294-1304.
22. Neal B, Perkovic V, Mahaffey KW, de Zeeuw D, Fulcher G, Erondu N, et al. CANVAS Program Collaborative Group: canagliflozin and cardiovascular and renal events in type 2 diabetes. N Engl JMed. 2017;377:644–57.
23. Clifford J, Day C, Srikanth B. Renal Protection with SGLT2 Inhibitors: Effects in Acute and Chronic Kidney Disease. Current Diabetes Reports 2022 22:39–52. https://doi.org/10.1007/s11892-021-01442-z
24. Garnica C, Lavalle J, Magaña A, et al. Documento de consenso sobre el uso de los iSGLT2 en el tratamiento de pacientes con diabetes mellitus tipo 2. Gaceta Medica De México, 2023: 158(71). https://doi.org/10.24875/gmm.m21000596
25. Cannon C, Pratley R, Dagogo‐Jack S et al. Cardiovascular Outcomes with Ertugliflozin in Type 2 Diabetes. N Engl JMed. 2020. 383(15), 142 1435. https://doi.org/10.1056/nejmoa2004967
26. Packer M, Wilcox C, Testani M. Critical Analysis of the Effects of SGLT2 Inhibitors on Renal Tubular Sodium, Water and Chloride Homeostasis and Their Role in Influencing Heart Failure Outcomes. Circulation 2023, 148(4), 354-372. https://doi.org/10.1161/circulationaha.123.064346
27. Beitelshees A, Leslie B, Taylor S. Sodium-glucose cotransporter 2 inhibitors: A case study in translational research. Diabetes., (2019), 68 pp. 1109-1120 http://dx.doi.org/10.2337/dbi18-0006
28. Furtado R, Raz I, Goodrich E, et al. DECLARE – TIMI 58 Investigators , Efficacy and safety of dapagliflozin according to baseline blood pressure – observations from DECLARE-TIMI 58 Trial, European Heart Journal, Volume 41, Issue Supplement_2, November 2020, ehaa946.3063, https://doi.org/10.1093/ehjci/ehaa946.3063
29. Loiola, P. E. (2020). Inhibidores de la SGLT2. ¿Cuál es el lugar en terapéutica? FMC. Formación Médica Continuada En Atención Primaria/ 27(8), 419–427. https://doi.org/10.1016/j.fmc.2020.01.007
30. Mei Q, Liang-Liang D, Miao Z et al. Safety of four SGLT2 inhibitors in three chronic diseases: A meta-analysis of large randomized trials of SGLT2 inhibitors. Diabetes & Vascular Disease 2021. March-April 2021: 1–3. DOI: 10.1177/14791641211011016
2. Han, L., Qu, Q., Aydin, D. et al. Structure and mechanism of the SGLT family of glucose transporters. Nature.601, 274–279 (2022). https://doi.org/10.1038/s41586-021-04211-w
3. Yoshifumi S. SGLT2 Inhibitors: The Star in the Treatment of Type 2 Diabetes?. Diseases 2020, 8, 14; doi:10.3390/diseases8020014
4. Merlin T, Brendon N, Stephen T et al. SGLT2 inhibitors for patients with type 2 diabetes and CKD: a narrative review. Endocrine Connections 2023. 12,;e230005. https://doi.org/10.1530/EC-23-0005
5. Nelinson D, Sosa J, Chilton R. SGLT2 inhibitors: a narrative review of efficacy and safety J Osteopath Med 2021; 121(2): 229–239. https://doi.org/10.1515/jom-2020-0153
6. Yuwen C, Xin L, Gaosi X. Combination therapy with SGLT2 inhibitors for diabetic kidney disease. Biomedicine & Pharmacotherapy ELSEVIER 2020; 127:1-12. https://doi.org/10.1016/j.biopha.2020.110192
7. Eveline P, Louis H, Majon M et al. Diuretics, SGLT2 inhibitors and falls in older heart failure patients: to prescribe or to deprescribe? A clinical review. European Geriatric Medicine 2023. 14:659–674 https://doi.org/10.1007/s41999-023-00752-7
8. Neal B, Perkovic V, Mahaffey KW, et al. Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes. N Engl J Med. 2017;377(7):644-657. doi: 10.1056/NEJMoa1611925.
9. Zinman B, Wanner C, Lachin JM, et al. Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes. N Engl J Med. 2015;373(22):2117-28. doi: 10.1056/NEJMoa1504720.
10. Suzuki Y, Kaneko K, Okadaet A et al. Comparison of cardiovascular outcomes between SGLT2 inhibitors in diabetes mellitus. Cardiovascular Diabetology. 2022;21:67 https://doi.org/10.1186/s12933-022-01508-6
11. Pardeep S, John J, McMurray M. Efficacy of Dapagliflozin on Renal Function and Outcomes in Patients With Heart Failure With Reduced Ejection Fraction. Circulation 2021. 2021;143:298–309. DOI: 10.1161/CIRCULATIONAHA.120.050391
12. Wiviott SD, Raz I, Bonaca MP, et al. Dapagliflozin and Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med. 2019;380(4):347-357.
13. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes. Diabetes Care 2024;47(Suppl. 1):S179–S218 | https://doi.org/10.2337/dc24-S010
14. Packer M, Anker S, Butler J et al. Cardiovascular and Renal Outcomes with Empagliflozin in Heart Failure N Engl J Med 2020;383:1413-1424. DOI: 10.1056/NEJMoa20221
15. ESC Guidelines for the management of cardiovascular disease in patients with diabetes. 2023 ESC Clinical Practice Guidelines. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/CVD-and-Diabetes-Guidelines
16. Dharia A, Khan A, Vikas S et al. SGLT2 Inhibitors: The Sweet Success for Kidneys. Annu. Rev. Med. 2023. 74:369–84. https://doi.org/10.1146/annurev-med-042921- 102135
17. Nishiyama A, Kento K. Possible renoprotective mechanisms of SGLT2 inhibitors. Front Med 2023. 10:1115413. doi: 10.3389/fmed.2023.1115413
18. Podestà M; Sabiu G, Galassi A et al. SGLT2 Inhibitors in Diabetic and Non-Diabetic Chronic Kidney Disease. Biomedicines 2023, 11, 279. https://doi.org/10.3390/ biomedicines11020279
19. Yau K, Dharia A, Alrowiyti, I et al. Prescribing SGLT2 inhibitors in patients with CKD: Expanding indications and practical considerations. Kidney International Reports 2022; 7(7), 1463–1476. https://doi.org/10.1016/j.ekir.2022.04.094
20. Heerspink H, Stefánsson BV, Correa-Rotter R, et al. Dapagliflozin in patients with chronic kidney disease. N Engl J Med 2020; 15: 1436–1446.
21. Chen TK, Knicely DH, Grams ME. Chronic Kidney Disease Diagnosis and Management: A Review. JAMA. 2019;322(13):1294-1304.
22. Neal B, Perkovic V, Mahaffey KW, de Zeeuw D, Fulcher G, Erondu N, et al. CANVAS Program Collaborative Group: canagliflozin and cardiovascular and renal events in type 2 diabetes. N Engl JMed. 2017;377:644–57.
23. Clifford J, Day C, Srikanth B. Renal Protection with SGLT2 Inhibitors: Effects in Acute and Chronic Kidney Disease. Current Diabetes Reports 2022 22:39–52. https://doi.org/10.1007/s11892-021-01442-z
24. Garnica C, Lavalle J, Magaña A, et al. Documento de consenso sobre el uso de los iSGLT2 en el tratamiento de pacientes con diabetes mellitus tipo 2. Gaceta Medica De México, 2023: 158(71). https://doi.org/10.24875/gmm.m21000596
25. Cannon C, Pratley R, Dagogo‐Jack S et al. Cardiovascular Outcomes with Ertugliflozin in Type 2 Diabetes. N Engl JMed. 2020. 383(15), 142 1435. https://doi.org/10.1056/nejmoa2004967
26. Packer M, Wilcox C, Testani M. Critical Analysis of the Effects of SGLT2 Inhibitors on Renal Tubular Sodium, Water and Chloride Homeostasis and Their Role in Influencing Heart Failure Outcomes. Circulation 2023, 148(4), 354-372. https://doi.org/10.1161/circulationaha.123.064346
27. Beitelshees A, Leslie B, Taylor S. Sodium-glucose cotransporter 2 inhibitors: A case study in translational research. Diabetes., (2019), 68 pp. 1109-1120 http://dx.doi.org/10.2337/dbi18-0006
28. Furtado R, Raz I, Goodrich E, et al. DECLARE – TIMI 58 Investigators , Efficacy and safety of dapagliflozin according to baseline blood pressure – observations from DECLARE-TIMI 58 Trial, European Heart Journal, Volume 41, Issue Supplement_2, November 2020, ehaa946.3063, https://doi.org/10.1093/ehjci/ehaa946.3063
29. Loiola, P. E. (2020). Inhibidores de la SGLT2. ¿Cuál es el lugar en terapéutica? FMC. Formación Médica Continuada En Atención Primaria/ 27(8), 419–427. https://doi.org/10.1016/j.fmc.2020.01.007
30. Mei Q, Liang-Liang D, Miao Z et al. Safety of four SGLT2 inhibitors in three chronic diseases: A meta-analysis of large randomized trials of SGLT2 inhibitors. Diabetes & Vascular Disease 2021. March-April 2021: 1–3. DOI: 10.1177/14791641211011016