Balancing the Benefits and Risks of SGLT2 Inhibitors
Koristi in pasti zdravljenja s SGLT-2 zaviralci
DOI:
https://doi.org/10.18690/actabiomed.300Ključne besede:
SGLT-2 zaviralci, sladkorna bolezen tipa 2, kronična ledvična bolezen, srčno popuščanje, klinični izidiPovzetek
Srčnožilne, ledvične in presnovne bolezni so eden izmed vodilnih vzrokov obolevnosti in umrljivosti po svetu. Zaviralci natrij–glukoznega kotransporterja 2 (angl. sodium-glucose cotransporter-2 inhibitors, SGLT2i) so izkazali pomembne koristi, ki presegajo zgolj uravnavanje glikemije. V preglednem članku so obravnavani trenutno dostopni dokazi o ledvičnih, srčnožilnih in presnovnih učinkih SGLT2i s poudarkom na ključnih kliničnih raziskavah o njihovi uporabi.
Z zaviranjem ponovnega privzema natrija in glukoze v proksimalnem ledvičnem tubulu SGLT2i ponovno vzpostavijo tubuloglomerularno povratno zanko, zmanjšajo intraglomerularni tlak in zmanjšajo glomerularno hiperfiltracijo, s čimer upočasnijo napredovanje kronične ledvične bolezni. Večje randomizirane kontrolirane raziskave so pokazale zmanjšanje števila hospitalizacij zaradi srčnega popuščanja ter zmanjšanje srčnožilne umrljivosti, in to tudi pri populacijah brez sladkorne bolezni. Poleg tega imajo SGLT2i številne ugodne metabolne sistemske učinke, vključno z zmernim zmanjšanjem telesne teže in krvnega tlaka, izboljšano presnovno učinkovitostjo, ter tudi modulacijo vnetja in oksidativnega stresa.
V obravnavo so prav tako zajeti neželeni učinki, vključno z genitourinarnimi okužbami, hipovolemijo, prehodnim poslabšanjem ledvične funkcije ter redkimi zapleti, kot sta diabetična ketoacidoza in Fournierjeva gangrena.
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Avtorske pravice (c) 2026 Alex Forštnarič, Ana Stajan, Nejc Piko (Author)
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