Impact of Sodium-Glucose Cotransporter-2 Inhibitors in the Management of Chronic Kidney Disease: A Middle East and Africa Perspective

Ahmed Fathi Elkeraie; Saeed Al-Ghamdi; Ali K Abu-Alfa; Torki Alotaibi; Ali Jasim AlSaedi; Abdulkareem AlSuwaida; Mustafa Arici; Tevfik Ecder; Mohammad Ghnaimat; Mohamed Hany Hafez; Mohamed H Hassan; Tarik Sqalli

doi:10.2147/IJNRD.S430532

Impact of Sodium-Glucose Cotransporter-2 Inhibitors in the Management of Chronic Kidney Disease: A Middle East and Africa Perspective

Int J Nephrol Renovasc Dis. 2024 Jan 3:17:1-16. doi: 10.2147/IJNRD.S430532. eCollection 2024.

Authors

Affiliations

¹ Department of Internal Medicine and Nephrology, Alexandria University, Alexandria, Egypt.
² Department of Medicine, College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
³ Department of Internal Medicine, Division of Nephrology and Hypertension, American University of Beirut, Beirut, Lebanon.
⁴ Transplant Nephrology, Hamed Al-Essa Organ Transplant Center, Sabah Health Region, Kuwait City, Kuwait.
⁵ Department of Nephrology, College of Medicine, University of Baghdad, Nephrology and Transplantation Center, Medical City Complex, Baghdad, Iraq.
⁶ Department of Medicine, King Saud University, Riyadh, Saudi Arabia.
⁷ Department of Nephrology, Faculty of Medicine, Hacettepe University, Altındağ, Ankara, Turkey.
⁸ Department of Medicine, Istinye University; Division of Nephrology, Topkapı, Istanbul, Turkey.
⁹ Department of Nephrology, Specialty Hospital, Jaber Ibn Hayyan St. Shmeisani, Amman, Jordan.
¹⁰ Department of Nephrology and Medicine, Cairo University, Cairo, Egypt.
¹¹ Department of Medicine, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates.
¹² Department of Nephrology, Moroccan Society of Nephrology, Casablanca, Morocco.

Abstract

Chronic kidney disease (CKD) is a major public health concern in the Middle East and Africa (MEA) region and a leading cause of death in patients with type 2 diabetes mellitus (T2DM) and hypertension. Early initiation of sodium-glucose cotransporter - 2 inhibitors (SGLT-2i) and proper sequencing with renin-angiotensin-aldosterone system inhibitors (RAASi) in these patients may result in better clinical outcomes due to their cardioprotective properties and complementary mechanisms of action. In this review, we present guideline-based consensus recommendations by experts from the MEA region, as practical algorithms for screening, early detection, nephrology referral, and treatment pathways for CKD management in patients with hypertension and diabetes mellitus. This study will help physicians take timely and appropriate actions to provide better care to patients with CKD or those at high risk of CKD.

Keywords: chronic kidney disease; nephrology referral; screening; sodium-glucose cotransporter-2 inhibitors.

Grants and funding

The preparation of this consensus manuscript and funding of the journal’s article processing charges were supported by AstraZeneca FZ, LLC. All authors had full access to all the data in this study and take complete responsibility for the integrity of the data and accuracy of the data analyses.