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Medicines
Dr. Joan J. Morales Lappot, MD
3 min read · Leer en español
SGLT2 inhibitors: the diabetes pills that also protect the kidneys
Dr. Joan J. Morales Lappot, MD3 min read · Leer en español
In briefWhen I say "less is more" with medicines, I mean every medicine should earn its place. SGLT2 inhibitors are one of the few that clearly have, for many people with kidney disease, with or without diabetes.
How they work
These medicines, such as empagliflozin (Jardiance) and dapagliflozin (Farxiga), make the kidneys release extra sugar and a little salt into the urine. That lowers pressure inside the kidney's filters, which seems to protect them over time. Large studies showed they slow the loss of kidney function and reduce heart failure hospitalizations.
Who may benefit
- People with chronic kidney disease, especially with protein in the urine
- People with type 2 diabetes and kidney disease
- People with heart failure
They are usually not used in type 1 diabetes, and they are started at a level of kidney function your doctor will check.
Stop and call if:
- You have nausea, vomiting, belly pain and unusual tiredness
- You feel faint or very dizzy
- You have pain, redness or swelling in the genital area with fever
What to expect
- A small, expected dip in eGFR in the first weeks, which usually stabilizes; it is not a reason to stop
- More urination at first
- A higher chance of genital yeast infections: good hygiene helps
- Hold the medicine when you are sick and not eating or drinking, and before surgery, to avoid a rare complication called ketoacidosis
Bottom line: For many people with kidney disease, an SGLT2 inhibitor is one of the most protective medicines available. Ask whether it fits you.
Questions about your kidneys?Call (954) 989-9553