What would be the clinical role of SGLT-2 inhibitors for lupus nephritis given it has an indication for proteinuria related to CKD?
The benefit for SGLT-2 inhibitors at slowing the progression of kidney disease or death from cardiovascular causes had been well established in patients with diabetic nephropathy. Further studies continued to demonstrate benefit in non-diabetic, proteinuric kidney disease (HR, 0.72 (95% CI, 0.64-0.8...
I think there is a role for SGLT2 for any patient with (glomerular?) proteinuria. But you have to consider the lesion and the prognosis. For instance, if the patient had Class 2 with < a gram that patient had a good prognosis and I think you are wasting money. If the patient had persistent nephrotic...
My typical diabetic patient dealing with renal and cardiac issues is now on over a dozen medications. The cost and complexity of these regimens are becoming excessive, and many are beginning to refuse them. A family member asked me if “I’d lost my mind” to expect their mother to take 14 different dr...
I think this will be a really tough question to answer and will ultimately require a clinical trial (or more than one).
From a kidney perspective the biggest question is what are you treating?
A lot of patients have residual proteinuria that may not be immune mediated, and can be the result of scarr...
This question plays right into an opinion I have about the almost universal use of SGLT 2 inhibitors in renal diseases. It seems that they are now being considered from everything and every type of renal disease. I think it's important for us to be careful. The mechanism is thought to be hemodynamic...
More definitive answers are yet to come. But I urge you to view Dr. April Jorge's presentation from ACR this year for the latest: