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End-stage renal failure is a common and devastating consequence of type 2 diabetes. Sodium-glucose cotransporter-2 (SGLT2) inhibitors, in combination with angiotensin-converting enzyme inhibitors (ACEI) and angiotensin II receptor antagonists (ARBs), reduce cardiovascular events and deterioration of renal disease in patients with type 2 diabetes and renal impairment.
Type 2 diabetes is a global epidemic.1 It is the third most frequent cause of disability in high-income countries and the most common cause in most low-income countries.1 Much of this disability relates from renal impairment caused by uncontrolled blood glucose levels; as many as 40% of patients with diabetes will develop kidney disease.2 The presence of renal impairment in patients with type 2 diabetes has many consequences—chiefly, these patients are at substantial risk of cardiovascular disease and, often in <10 years, progress to end-stage renal failure.3 Currently, the only medicines approved for renoprotective in patients with diabetes are renin–angiotensin blockers, namely ACEI and ARBs.4 The CREDENCE trial tested the effect of …
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