{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T09:29:52Z","timestamp":1762507792886,"version":"3.37.3"},"reference-count":84,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2019,8,14]],"date-time":"2019-08-14T00:00:00Z","timestamp":1565740800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Ben J. Lipps Research Fellowship"},{"DOI":"10.13039\/100001463","name":"American Society of Nephrology","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001463","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"name":"NIDDK K23","award":["1K23DK100447"],"award-info":[{"award-number":["1K23DK100447"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Chronic kidney disease (CKD) is a critical global public health problem associated with high morbidity and mortality, poorer quality of life and increased health care expenditures. CKD and its associated comorbidities are one of the most complex clinical constellations to manage. Treatments for CKD and its comorbidities lead to polypharmacy, which exponentiates the morbidity and mortality. Sodium-glucose cotransporter 2 inhibitors (SGLT2is) have shown remarkable benefits in cardiovascular and renal protection in patients with type 2 diabetes mellitus (T2DM). The pleiotropic effects of SGLT2is beyond glycosuria suggest a promising role in reducing polypharmacy in diabetic CKD, but the potential adverse effects of SGLT2is should also be considered. In this review, we present a typical case of a patient with multiple comorbidities seen in a CKD clinic, highlighting the polypharmacy and complexity in the management of proteinuria, hyperkalemia, volume overload, hyperuricemia, hypoglycemia and obesity. We review the cardiovascular and renal protection effects of SGLT2is in the context of clinical trials and current guidelines. We then discuss the roles of SGLT2is in the management of associated comorbidities and review the adverse effects and controversies of SGLT2is. We conclude with a proposal for deprescribing principles when initiating SGLT2is in patients with diabetic CKD.<\/jats:p>","DOI":"10.1093\/ckj\/sfz100","type":"journal-article","created":{"date-parts":[[2019,7,9]],"date-time":"2019-07-09T15:10:42Z","timestamp":1562685042000},"page":"620-628","source":"Crossref","is-referenced-by-count":13,"title":["Sodium-glucose cotransporter 2 inhibitors for diabetic kidney disease: a primer for deprescribing"],"prefix":"10.1093","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1342-3945","authenticated-orcid":false,"given":"Jiahua","family":"Li","sequence":"first","affiliation":[{"name":"Renal Division, Department of Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA, USA"},{"name":"Renal Section, VA Boston Healthcare System, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher O","family":"Fagbote","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, VA Boston Healthcare System, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min","family":"Zhuo","sequence":"additional","affiliation":[{"name":"Renal Division, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chelsea E","family":"Hawley","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, VA Boston Healthcare System, Boston, MA, USA"},{"name":"New England Geriatric Research Education and Clinical Center, VA Boston Healthcare System, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie M","family":"Paik","sequence":"additional","affiliation":[{"name":"Renal Division, Department of Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA, USA"},{"name":"Renal Section, VA Boston Healthcare System, Boston, MA, USA"},{"name":"New England Geriatric 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