I was listen to a Dr. in a podcast regarding new treatment for CDK. Even though these sodium inhibitors are used for heart patience and diabetics, they are showing promising results for non-diabetics with CKD and proteinuria.
"Despite optimal treatment with renin-angiotensin-aldosterone-system (RAAS) inhibitors, many patients with non-diabetic kidney disease show progressive kidney function loss, which is associated with high residual proteinuria. Novel treatment strategies are therefore required to further decrease proteinuria and to slow kidney function decline."
Dapagliflozin is a sodium-glucose transport (SGLT2) inhibitor and inhibits the reabsorption of glucose and sodium in the proximal tubule. The increased natriuresis following dapagliflozin administration normalizes tubuloglomerular feedback resulting in a reduction in intra-glomerular hypertension, which is in turn manifested by acute reversible reductions in glomerular filtration rate and albuminuria. Since many etiologies of non-diabetic nephropathy are characterized by intraglomerular hypertension, we hypothesize that dapagliflozin acutely decreases GFR and proteinuria in patients without diabetes at risk of progressive kidney function loss via a glucose independent hemodynamic mechanism.
"SGLT2 INHIBITORS IMPROVE CV OUTCOMES ALSO IN NON-DIABETIC PATIENTS WITH HF The first large Phase 3 trial of SGLT2 inhibitors enrolling non-diabetic patients in addition to diabetics was the Dapagliflozin and Prevention of Adverse Outcomes in Heart Failure (DAPA-HF) trial."