{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T23:10:26Z","timestamp":1790982626461,"version":"4.1.0"},"reference-count":92,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,8,14]],"date-time":"2024-08-14T00:00:00Z","timestamp":1723593600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008349","name":"Boehringer Ingelheim","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008349","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Chronic kidney disease (CKD) affects approximately 13% of people globally, including 20%\u201348% with type 2 diabetes (T2D), resulting in significant morbidity, mortality, and healthcare costs. There is an urgent need to increase early screening and intervention for CKD. We are experts in diabetology and nephrology in Central Europe and Israel. Herein, we review evidence supporting the use of sodium\u2010glucose cotransporter\u20102 (SGLT2) inhibitors for kidney protection and discuss barriers to early CKD diagnosis and treatment, including in our respective countries. SGLT2 inhibitors exert cardiorenal protective effects, demonstrated in the renal outcomes trials (EMPA\u2010KIDNEY, DAPA\u2010CKD, CREDENCE) of empagliflozin, dapagliflozin, and canagliflozin in patients with CKD. EMPA\u2010KIDNEY demonstrated cardiorenal efficacy across the broadest renal range, regardless of T2D status. Renoprotective evidence also comes from large real\u2010world studies. International guidelines recommend first\u2010line SGLT2 inhibitors for patients with T2D and estimated glomerular filtration rate (eGFR) \u226520\u2009mL\/min\/1.73\u2009m\n                    <jats:sup>2<\/jats:sup>\n                    , and that glucagon\u2010like peptide\u20101 receptor agonists may also be administered if required for additional glucose control. Although these guidelines recommend at least annual eGFR and urine albumin\u2010to\u2010creatinine ratio screening for patients with T2D, observational studies suggest that only half are screened. Diagnosis is hampered by asymptomatic early CKD and under\u2010recognition among patients with T2D and clinicians, including limited knowledge\/use of guidelines and resources. Based on our experience and on the literature, we recommend robust screening programmes, potentially with albuminuria self\u2010testing, and SGLT2 inhibitor reimbursement at general practitioner (GP) and specialist levels. High\u2010tech tools (artificial intelligence, smartphone apps, etc.) are providing exciting opportunities to identify high\u2010risk individuals, self\u2010screen, detect abnormalities in images, and assist with prescribing and treatment adherence. Better education is also needed, alongside provision of concise guidelines, enabling GPs to identify who would benefit from early initiation of renoprotective therapy; although, regardless of current renal function, cardiorenal protection is provided by SGLT2 inhibitor therapy.\n                  <\/jats:p>","DOI":"10.1111\/dom.15789","type":"journal-article","created":{"date-parts":[[2024,8,14]],"date-time":"2024-08-14T05:37:05Z","timestamp":1723613825000},"page":"4165-4177","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Barriers to early diagnosis of chronic kidney disease and use of sodium\u2010glucose cotransporter\u20102 inhibitors for renal protection: A comprehensive review and call to action"],"prefix":"10.1111","volume":"26","author":[{"given":"Leszek","family":"Czupryniak","sequence":"first","affiliation":[{"name":"Department of Diabetology and Internal Medicine Medical University of Warsaw  Warsaw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ofri","family":"Mosenzon","sequence":"additional","affiliation":[{"name":"Diabetes Unit, Department of Endocrinology and Metabolism, Hadassah Medical Centre, Faculty of Medicine Hebrew University of Jerusalem  Jerusalem Israel"},{"name":"Faculty of Medicine Hebrew University of Jerusalem  Jerusalem Israel"},{"name":"Regeneron Pharmaceuticals  Tarrytown New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4245-5949","authenticated-orcid":false,"given":"Ivan","family":"Rychl\u00edk","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Third Faculty of Medicine Charles University  Prague Czech Republic"},{"name":"University Hospital Kr\u00e1lovsk\u00e9 Vinohrady  Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Clodi","sequence":"additional","affiliation":[{"name":"Hospital of Internal Medicine Br\u00fcder Linz  Linz Austria"},{"name":"Institute for Cardiovascular and Metabolic Research (ICMR) Johannes Kepler Universit\u00e4t Linz (JKU Linz)  Linz Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fahim","family":"Ebrahimi","sequence":"additional","affiliation":[{"name":"University Digestive Health Care Centre Basel\u2014Clarunis  Basel Switzerland"},{"name":"Department of Medical Epidemiology and Biostatistics Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6594-5254","authenticated-orcid":false,"given":"Andrej","family":"Janez","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Diabetes and Metabolic Diseases, Medical Centre University of Ljubljana Medical Faculty  Ljubljana Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Kempler","sequence":"additional","affiliation":[{"name":"Department of Medicine and Oncology Semmelweis University  Budapest Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maciej","family":"Ma\u0142ecki","sequence":"additional","affiliation":[{"name":"Department of Metabolic Diseases Jagiellonian University Medical College  Krak\u00f3w Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evgeny","family":"Moshkovich","sequence":"additional","affiliation":[{"name":"Diabetes and Endocrinology Clinic Clalit Medical Services  Ramat Gan Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Pr\u00e1zn\u00fd","sequence":"additional","affiliation":[{"name":"3rd Department of Internal Medicine, 1st Faculty of Medicine Charles University in Prague  Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3510-9594","authenticated-orcid":false,"given":"Harald","family":"Sourij","sequence":"additional","affiliation":[{"name":"Interdisciplinary Metabolic Medicine Trials Unit, Division of Endocrinology and Diabetology Medical University of Graz  Graz Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsvetalina","family":"Tankova","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Medical University \u2010 Sofia  Sofia Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bogdan","family":"Timar","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine \u201cVictor Babes\u201d University of Medicine and Pharmacy  Timisoara Romania"},{"name":"Centre for Molecular Research in Nephrology and Vascular Disease \u201cVictor Babes\u201d University of Medicine and Pharmacy  Timisoara Romania"},{"name":"Diabetes Clinic \u201cPius Brinzeu\u201d Emergency Hospital  Timisoara Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,8,14]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/kisup.2012.64"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.2337\/dci22-0027"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30045-3"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0158765"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanepe.2022.100438"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinthera.2021.07.015"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.14401"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2022-065927"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.13303"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1159\/000504558"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.15485"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.endinu.2021.08.002"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2012070718"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1080\/00325481.2021.2009726"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-021-02394-y"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcd.2020.05.005"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcjd.2022.01.008"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjdrc-2022-002806"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2023.02.1082"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0221325"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfab089"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-020-1705-3"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1811744"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2024816"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2204233"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-022-01575-9"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1504720"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1515920"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1611925"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1812389"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc23-S011"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1071\/PY17156"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.57187\/smw.2023.40004"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.5114\/ctd\/160061"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz486"},{"key":"e_1_2_10_37_1","unstructured":"Symptoms Chronic kidney disease.https:\/\/www.nhs.uk\/conditions\/kidney-disease\/symptoms\/"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-022-01631-4"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-020-01154-w"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-021-02381-3"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1530\/EC\u201023\u20100005"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00508-022-02147-3"},{"key":"e_1_2_10_43_1","first-page":"104","article-title":"Doporu\u010den\u00e9 postupy p\u0159i diabetick\u00e9m onemocn\u011bn\u00ed ledvin","volume":"29","author":"Pelik\u00e1nov\u00e1 T","year":"2021","journal-title":"Klin Biochem Metab"},{"key":"e_1_2_10_44_1","unstructured":"Chronic kidney disease: Screening.https:\/\/bestpractice.bmj.com\/topics\/en-gb\/84\/screening"},{"key":"e_1_2_10_45_1","unstructured":"ISN\u2010KDIGO Early Screening Booklet.https:\/\/www.theisn.org\/wp\u2010content\/uploads\/2023\/02\/ISN_KDIGO_EarlyScreeningBooklet_PRINT_Updated.pdf"},{"key":"e_1_2_10_46_1","unstructured":"eGFR Calculator.https:\/\/www.kidney.org\/professionals\/kdoqi\/gfr_calculator"},{"key":"e_1_2_10_47_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2021.08.003"},{"key":"e_1_2_10_48_1","doi-asserted-by":"publisher","DOI":"10.7326\/M22-2904"},{"key":"e_1_2_10_49_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-021-01659-1"},{"key":"e_1_2_10_50_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2107038"},{"key":"e_1_2_10_51_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.121.056824"},{"key":"e_1_2_10_52_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.120.051783"},{"key":"e_1_2_10_53_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1911303"},{"key":"e_1_2_10_54_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.1906"},{"key":"e_1_2_10_55_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.034222"},{"key":"e_1_2_10_56_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc23-S009"},{"key":"e_1_2_10_57_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-43614-9"},{"key":"e_1_2_10_58_1","unstructured":"AstraZeneca.https:\/\/www.forxiga.co.uk\/content\/dam\/intelligentcontent\/brands\/forxiga\u2010uk\/en\/resources\/pdf\/SGLT2i_dosing_considerations_according_to_eGFR_when_treating_T2D_HF_or_CKD_April_2023_A4.pdf#:\u223c:text=The%20glucose%20lowering%20eficacy%20of%20dapagliflozin%20is%20dependent likely%20absent%20in%20patients%20with%20severe%20renal%20impairment."},{"key":"e_1_2_10_59_1","unstructured":"Boehringer Ingelheim.https:\/\/pro.boehringer\u2010ingelheim.com\/us\/products\/jardiance\/cv\u2010disease\/efficacy#:\u223c:text=JARDIANCE%20is%20not%20recommended%20for%20use%20to%20improve this%20setting%20based%20upon%20its%20mechanism%20of%20action."},{"key":"e_1_2_10_60_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms20235831"},{"key":"e_1_2_10_61_1","unstructured":"European Kidney Patients Federation.The realities of living with CKD: People with T2D and CKD speak up.https:\/\/ekpf.eu\/wp\u2010content\/uploads\/2023\/03\/EKPF\u2010Designed\u2010Patient\u2010Insights\u2010Report_FINAL.pdf"},{"key":"e_1_2_10_62_1","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfab070"},{"key":"e_1_2_10_63_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc20-2715"},{"key":"e_1_2_10_64_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gft351"},{"key":"e_1_2_10_65_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph182211752"},{"key":"e_1_2_10_66_1","unstructured":"Ministry of Health Israel.National Program of Quality Indicators Report Years 2015\u20132019.https:\/\/en.israelhealthindicators.org\/_files\/ugd\/76a237_d825102a7f984348a6debd5bccf78768.pdf"},{"key":"e_1_2_10_67_1","doi-asserted-by":"publisher","DOI":"10.4414\/SMW.2022.w30197"},{"key":"e_1_2_10_68_1","unstructured":"KvapilM.Je n\u00e1m k n\u011b\u010demu dobr\u00fd N\u00e1rodn\u00ed diabetologick\u00fd registr?2022."},{"key":"e_1_2_10_69_1","doi-asserted-by":"publisher","DOI":"10.37765\/ajmc.2022.89211"},{"key":"e_1_2_10_70_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0215016"},{"key":"e_1_2_10_71_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40620-022-01353-6"},{"key":"e_1_2_10_72_1","doi-asserted-by":"publisher","DOI":"10.2196\/50737"},{"key":"e_1_2_10_73_1","doi-asserted-by":"publisher","DOI":"10.2196\/44996"},{"key":"e_1_2_10_74_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.xkme.2021.03.009"},{"key":"e_1_2_10_75_1","doi-asserted-by":"publisher","DOI":"10.1590\/2175-8239-jbn-2018-0101"},{"key":"e_1_2_10_76_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2023.102414"},{"key":"e_1_2_10_77_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics14040397"},{"key":"e_1_2_10_78_1","doi-asserted-by":"publisher","DOI":"10.1111\/nep.14113"},{"key":"e_1_2_10_79_1","first-page":"2458","article-title":"SGLT2 inhibitors in chronic kidney disease: from mechanisms to clinical practice","volume":"10","author":"Skrabic R","year":"2022","journal-title":"Biomedicine"},{"key":"e_1_2_10_80_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41581-020-00350-x"},{"key":"e_1_2_10_81_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2030186"},{"key":"e_1_2_10_82_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.0000000000000414"},{"key":"e_1_2_10_83_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(23)00322-4"},{"key":"e_1_2_10_84_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(23)00321-2"},{"key":"e_1_2_10_85_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(19)30384-5"},{"key":"e_1_2_10_86_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m1186"},{"key":"e_1_2_10_87_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.15111"},{"key":"e_1_2_10_88_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.14239"},{"key":"e_1_2_10_89_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.0000000000000218"},{"key":"e_1_2_10_90_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.15172"},{"key":"e_1_2_10_91_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabet.2022.101418"},{"key":"e_1_2_10_92_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.029190"},{"key":"e_1_2_10_93_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.03.009"}],"container-title":["Diabetes, Obesity and Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dom-pubs.pericles-prod.literatumonline.com\/doi\/pdf\/10.1111\/dom.15789","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T04:55:37Z","timestamp":1761886537000},"score":1,"resource":{"primary":{"URL":"https:\/\/dom-pubs.pericles-prod.literatumonline.com\/doi\/10.1111\/dom.15789"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,14]]},"references-count":92,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2024,10]]}},"alternative-id":["10.1111\/dom.15789"],"URL":"https:\/\/doi.org\/10.1111\/dom.15789","archive":["Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.1111\/DOM.15789\/v1\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.15789\/v2\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.15789\/v2\/response1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.15789\/v1\/review4","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.15789\/v1\/review3","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.15789\/v1\/review2","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.15789\/v1\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.15789\/v2\/review1","asserted-by":"object"}]},"ISSN":["1462-8902","1463-1326"],"issn-type":[{"value":"1462-8902","type":"print"},{"value":"1463-1326","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,14]]},"assertion":[{"value":"2024-02-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-06-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-08-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}