The Role of Sodium-Glucose Cotransporter-2 Inhibitors in the Treatment Paradigm of CKD in Africa: An African Association of Nephrology Panel Position Paper

Abstract

Chronic kidney disease (CKD), a global public health problem, is increasing at an alarming rate across Africa. The increasing CKD burden in this region is mainly driven by a rapid surge in the prevalence of risk factors including diabetes, hypertension, obesity, and infectious diseases. To further aggravate the situation, CKD is known to progress rapidly to kidney failure (KF) in patients of African ethnicity. Given the serious health implications and prohibitively expensive treatment, it is paramount to focus on novel therapeutic prospects in CKD management to delay its progression to KF, prevent complications, and prolong survival. In recent years, substantial clinical and real-world evidence confirmed the cardiorenal protective benefits of sodium-glucose cotransporter-2 inhibitors (SGLT2is) in patients with CKD, with or without diabetes. In this context, a steering committee meeting was convened with 13 key experts from the African Association of Nephrology (AFRAN) to discuss the epidemiology and magnitude of region-specific CKD burden, unmet needs and challenges, and implications of SGLT2i use in CKD management. This paper summarizes the expert views and opinions on the applicability of SGLT2is in different populations with CKD to support their safe implementation in clinical practice with a focus on reducing the CKD burden in the region.