How Low Can You Go? Safety and Efficacy of Sodium-Glucose Cotransporter Inhibitors in Decreased Renal Function

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Sodium-glucose cotransporter 2 (SGLT2) inhibitors are a class of medications primarily used as either monotherapy or add-on therapy in those with type 2 diabetes. Given the mechanism of SGLT2 inhibitors, a renal dose adjustment or glomerular filtration rate cutoff in which it should be avoided due to decreased efficacy is recommended. However, studies have shown that these agents may possess renal benefits through decreasing serum glucose levels as well as decreasing intraglomerular pressure and albuminuria. The safety and benefits of SGLT2 inhibitors in patients with decreased renal function is an area of uncertainty.


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