SGLT-2 inhibitors in peritoneal dialysis: A new dawn for cardio-renal protection

The rising global incidence of chronic kidney disease has positioned peritoneal dialysis (PD) as a critical renal replacement therapy. However, its long-term efficacy is often compromised by peritoneal fibrosis and encapsulating peritoneal sclerosis, leading to treatment failure in kidney failure patients. Furthermore, this population faces compounded health challenges, including heightened cardiovascular risk and metabolic syndrome. Sodium-glucose co-transporter 2 (SGLT-2) inhibitors, initially developed as anti-diabetic agents, have garnered significant attention for their demonstrated clinical benefits in renal and cardiovascular protection, as well as metabolic improvement. This review aims to comprehensively analyze the mechanisms of action and clinical application prospects of SGLT-2 inhibitors in PD patients, synthesizing evidence from preclinical studies, observational data, and extrapolated findings from trials in chronic kidney disease (CKD) populations. By synthesizing existing literature, we seek to provide insights for clinical practice and illuminate future research directions.