Kidney Matters - Issue 6, Summer 2019


Kidney Matters is our free quarterly magazine for everyone affected by kidney disease.  This issue includes another recipe for our Kidney Kitchen as well as articles about dialysis transport, UK Kidney week, conservative treatment, and an interview with a retiring dialysis nurse after 33 years. We know that being a kidney patient can be tough at times and that accessing the right help at the right time isn’t always easy. We’ve spent a great deal of time over the past year talking to kidney patients on dialysis, asking them what we can do to address this. The response was overwhelmingly ‘improved communication’ on what is going on in the kidney world and what is available to them in terms of support and how to access it.  Kidney Matters has been developed to tackle this as well as the many other issues kidney patients face in day-to-day life. Along with shared patient experiences, Kidney Matters provides on how to access emotional and practical support, financial assistance through our grant schemes, advice from leading kidney specialists and tips on how to keep as well as possible by eating a healthy diet whilst on dialysis.



healthy people lose about 1 ml/min or 1% of kidney

function each year. So the people in the trial were

losing their kidney function at a very high rate, and we

were able to dramatically reduce this loss, not quite

back to normal, but certainly very significantly.”

The benefits seen in the study do not appear to be linked

to lower blood glucose levels. In fact, the effects on

blood glucose were less than that seen in other studies.

“Because SGLT2 inhibitors act through the kidney,

their ability to reduce blood sugar levels falls as

kidney function declines. Despite this, we saw these

profoundly beneficial effects on the kidney. I now

describe SGLT2 inhibitors as kidney drugs, rather than

medicines to lower glucose,” says Vlado.

Is the treatment safe?

In CREDENCE, canagliflozin seemed to be safe with no

unexpected side effects. There is known to be a higher

risk of thrush with SGLT2 inhibitors, because they

increase the amount of glucose in the urine. This can

usually be treated easily with a topical cream and there

is no need to stop the medication.

The only other cause for concern in CREDENCE was

diabetic ketoacidosis, a serious condition that occurs

when the body produces high levels of blood acids,

called ketones. This is uncommon in people with type 2

diabetes, but is more frequent with SGLT2 inhibitors.

“Everyone with diabetes

should have their kidney

function tested each year”


Figure 1: SGLT inhibitors and the kidney


Kidneys normally

reabsorb glucose

back into the body

Vlado adds: “In the trial, diabetic ketoacidosis occurred

in 11 people treated with canagliflozin compared to one

person receiving placebo. Everyone recovered, but it is

something we need to keep in mind. However, there were

none of the other adverse effects seen in other studies

that might have been associated with SGLT2 inhibitors,

such as fractures or amputations. This suggests that

treatment with canagliflozin was overall very safe.”

Reabsorption of

glucose is blocked

by SGLT inhibitor

The blood takes

glucose to the kidneys

Glucoses now passes

out of the body in the

urine, so lowering blood


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