Invokana ( Canagliflozin ) has been approved by the U.S. Food and Drug Administration ( FDA ) to reduce the risk of end-stage kidney disease ( ESKD ) and cardiovascular events in patients with type 2 diabetes and chronic kidney disease ( CKD ).
It is the first new treatment for diabetic kidney disease to be approved by the FDA in decades.
Diabetes and chronic kidney disease are common and complex disorders, which often co-exist, and each are associated with multiple comorbid conditions and higher risk for mortality.
SGLT2s are proteins found in the kidneys that are important in the reabsorption of glucose by the kidneys.
Canagliflozin, a SGLT2 inhibitor that is used for glycemic control in people with diabetes by inhibiting renal reabsorption of glucose, has now been shown to reduce the risk of kidney failure and heart disease in this population.
Diabetes is a key risk factor for chronic kidney disease, and accounts for 44% of all end stage renal disease cases.
However less than 40% of those with diabetes are completely assessed for kidney disease.
Two simple tests, an eGFR ( which assesses kidney function ) and an ACR ( which assesses kidney damage ) can diagnose kidney disease, and these tests results are also strong predictors of cardiovascular risk.
In the United States, 37 million adults are estimated to have chronic kidney disease. 1 in 3 American adults are at risk for chronic kidney disease.
Risk factors for kidney disease include diabetes, high blood pressure, heart disease, obesity and family history.
People of African American, Hispanic, Native American, Asian or Pacific Islander descent are at increased risk for developing the disease.
African Americans are 3 times more likely than Whites, and Hispanics are nearly 1.5 times more likely than non-Hispanics to develop end stage renal disease. ( Xagena )
Source: National Kidney Foundation, 2019