The toolkit on the optimization of SGLT2i therapy is the next output of a multi-society cardio-kidney-metabolic initiative, led by the ISN, to co-create toolkits for advancing the prevention and management of cardio-kidney complications.
The toolkit consists of focused and practical infographics, serving as hands-on references for nephrologists, cardiologists and other healthcare professionals involved in the multidisciplinary care of patients with cardio-kidney-metabolic complications.
Scroll down for educational and clinical infographics on:
- Nuts and Bolts of SGLT2i Therapy in the Intersection of Kidney and Cardiovascular Disease
- Practical Points for SGLT2 Inhibitor Usage
- Mitigate Adverse Effects of SGLT2 Inhibitors
- SGLT2 Inhibitor Cold Map
- Talking to Your Patients About SGLT2 Inhibitor Therapy
- Understanding SGLT2 Inhibitor Therapy
Additional resources developed as part of the wider CKM initiative can be found here.
Roberto Pecoits-Filho
ISN
Nephrologist
Angela Wang
ISN
Nephrologist
Charles Herzog
KDIGO
Cardiologist
Debasish Banerjee
ISN
Nephrologist
Giuseppe Rosano
HFA
Cardiologist
Martha Gulati
ASPC
Cardiologist
Edgar Lerma
RPA
Nephrologist
- Amina Rakisheva – Cardiologist
- Fadi Jouhra – Cardiologist
- Henry Wu – Nephrologist
- Michelle Carlson – Cardiologist
- Michelle Wong – Nephrologist
- Nedda Dastmalchi – Cardiologist
- Suman Behera – Nephrologist
- Viviane Calice-Silva – Nephrologist
Thank you also to the ISN Patient Liaison Advisory Group for their input into the patient tool.
- Writing Committee Members; ACC/AHA Joint Committee Members. 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure. J Card Fail. 2022 May;28(5):e1-e167. doi: 10.1016/j.cardfail.2022.02.010. Epub 2022 Apr 1. PMID: 35378257.
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American Diabetes Association. Standards of Medical Care in Diabetes-2022 Abridged for Primary Care Providers. Clin Diabetes. 2022 Jan;40(1):10-38. doi: 10.2337/cd22-as01. PMID: 35221470; PMCID: PMC8865785.
- García Carro, C., Bedia Raba, A., Banegas Deras, E. J., Vigara, L. A., Valero San Cecilio, R., Cruzado Vega, L., Gavela, E., González, G. M. E., Pérez-Flores, I., & Sanchez-Bielsa, F. (2022). FC 116: SGLT2 inhibitors in kidney transplantation: A multicenter study. Nephrology Dialysis Transplantation, 37(Suppl_3). https://doi.org/10.1093/ndt/gfac124.001
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Krishnan A, Shankar M, Lerma EV, Wiegley N; GlomCon Editorial Team. Sodium Glucose Cotransporter 2 (SGLT2) Inhibitors and CKD: Are You a #Flozinator? Kidney Med. 2023 Feb 1;5(4):100608. doi: 10.1016/j.xkme.2023.100608. PMID: 36915368; PMCID: PMC10006698.
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Kidney Disease: Improving Global Outcomes (KDIGO) Glomerular Diseases Work Group. KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases. Kidney Int. 2021 Oct;100(4S):S1-S276. doi: 10.1016/j.kint.2021.05.021. PMID: 34556256.
- Kidney Disease: Improving Global Outcomes (KDIGO) Diabetes Work Group. KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease. Kidney Int. 2022;102(5S):S1-S127. doi: 10.1016/j.kint.2022.06.008.
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Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int. 2024 Apr;105(4S):S117-S314. doi: 10.1016/j.kint.2023.10.018. PMID: 38490803.
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McQuarrie EP, Gillis KA, Mark PB. Seven suggestions for successful SGLT2i use in glomerular disease – a standalone CKD therapy? Curr Opin Nephrol Hypertens. 2022 May 1;31(3):272-277. doi: 10.1097/MNH.0000000000000786. Epub 2022 Feb 25. PMID: 35220316.
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McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Butler J, Čelutkienė J, Chioncel O, Cleland JGF, Crespo-Leiro MG, Farmakis D, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam CSP, Lyon AR, McMurray JJV, Mebazaa A, Mindham R, Muneretto C, Francesco Piepoli M, Price S, Rosano GMC, Ruschitzka F, Skibelund AK; ESC Scientific Document Group. 2023 Focused Update of the 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2023 Oct 1;44(37):3627-3639. doi: 10.1093/eurheartj/ehad195. Erratum in: Eur Heart J. 2024 Jan 1;45(1):53. doi: 10.1093/eurheartj/ehad613. PMID: 37622666.
- 2023 Focused Update of the 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) With the special contribution of the Heart Failure Association (HFA) of the ESC.
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Yau K, Dharia A, Alrowiyti I, Cherney DZI. Prescribing SGLT2 Inhibitors in Patients With CKD: Expanding Indications and Practical Considerations. Kidney Int Rep. 2022 May 5;7(7):1463-1476. doi: 10.1016/j.ekir.2022.04.094. PMID: 35812300; PMCID: PMC9263228.
- Wheeler DC, Toto RD, Stefánsson BV, Jongs N, Chertow GM, Greene T, Hou FF, McMurray JJV, Pecoits-Filho R, Correa-Rotter R, Rossing P, Sjöström CD, Umanath K, Langkilde AM, Heerspink HJL; DAPA-CKD Trial Committees and Investigators. A pre-specified analysis of the DAPA-CKD trial demonstrates the effects of dapagliflozin on major adverse kidney eventsin patients with IgA nephropathy. Kidney Int. 2021 Jul;100(1):215-224. doi: 10.1016/j.kint.2021.03.033. Epub 2021 Apr 18. PMID: 33878338.
- Nuffield Department of Population Health Renal Studies Group; SGLT2 inhibitor Meta-Analysis Cardio-Renal Trialists’ Consortium. Impact of diabetes on the effects of sodium glucose co-transporter-2 inhibitors on kidney outcomes: collaborative meta-analysis of large placebo-controlled trials. Lancet. 2022 Nov 19;400(10365):1788-1801. doi: 10.1016/S0140-6736(22)02074-8. Epub 2022 Nov 6. PMID: 36351458; PMCID: PMC7613836
The optimisation of SGLT2i therapy toolkit is supported by unrestricted educational grants from AstraZeneca and Boehringer Ingelheim and its alliance partner, Lilly
This toolkit material is freely available for download by health care professionals and individual usage. For-profit organizations may link to toolkit materials with appropriate referencing but are not allowed to use the materials directly (including screenshots) in their own activities; and, where the toolkit materials are referenced with a link, society logos may not be used or displayed with the link. Non-profit organizations may link to the toolkit materials with appropriate referencing, and may promote the materials directly, but must seek permission for this first. If you have any questions concerning the rights to use these materials, please contact mmoorthy@theisn.org.
This toolkit is intended to facilitate decision making of health professionals in their daily practice. However, final decisions concerning an individual patient must be made by the responsible health professional(s) in consultation with the patient and caregiver as appropriate. All societies represented in this project decline any responsibilities for any damage caused by the use that may be made of the information provided in this toolkit.