...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Journal of Clinical Medicine Research >Renoprotective Effects of Additional SGLT2 inhibitor Therapy in Patients With Type 2 Diabetes Mellitus and Chronic Kidney Disease Stages 3b-4: A Real World Report From A Japanese Specialized Diabetes Care Center
【24h】

Renoprotective Effects of Additional SGLT2 inhibitor Therapy in Patients With Type 2 Diabetes Mellitus and Chronic Kidney Disease Stages 3b-4: A Real World Report From A Japanese Specialized Diabetes Care Center

机译：额外的SGLT2抑制剂疗法对2型糖尿病和慢性肾脏病3b-4期患者的肾脏保护作用：日本专业糖尿病护理中心的真实报道

获取原文
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Background: Large randomized clinical trials of patients with type 2 diabetes mellitus (T2DM) and at high risk for cardiovascular disease revealed that sodium-glucose cotransporter 2 (SGLT2) inhibitors significantly reduced renal events. However, the trials included small numbers of patients with moderate-to-severe chronic kidney disease (CKD). Therefore, the renoprotective effects of SGLT2 inhibitors remain unknown in T2DM patients complicated with impaired renal function. We examined if SGLT2 inhibitors conferred beneficial effects on kidney function in T2DM patients with CKD. Methods: We retrospectively recruited T2DM patients who were newly treated with add-on of SGLT2 inhibitors and suffered from moderate-to-severe renal impairment with CKD stages 3b-4 (15 estimated glomerular filtration rate (eGFR) 45 mL/min/1.73 msup2/sup), at initiation of SGLT2 inhibitor therapy. We analyzed T2DM patients with moderate-to-severe renal impairment who continued to use SGLT2 inhibitors for at least 1 year. We investigated the effects of SGLT2 inhibitor therapy on 1-year changes in eGFR and urinary protein excretion before and after the treatment. Results: We analyzed 42 T2DM patients with median eGFR of 40.4 mL/min/1.73 msup2/sup. One-year SGLT2 inhibitor therapy lowered median hemoglobin A1c (HbA1c) levels from 7.6% to 7.5% (not significant). Body weight and blood pressure were significantly decreased, and hemoglobin was significantly increased. The median value of eGFR after 1 year of SGLT2 inhibitor therapy was 41.0 mL/min/1.73 msup2/sup, with no significant difference compared with baseline. The annual decline in eGFR improved significantly after SGLT2 inhibitor therapy (eGFR: (median), pre: -3.8, vs. post: 0.1 mL/min/1.73 msup2/sup per year, P 0.01). We also found a significant decrease in urinary protein excretion after SGLT2 inhibitor therapy (urinary protein-to-creatinine ratio: (median), pre: 0.36, vs. post: 0.23 g/g creatinine, n = 35, P 0.01). Conclusions: This study revealed the promising observations that add-on treatment with SGLT2 inhibitors exerted significant renoprotective effects, culminating in improvements in annual decline in eGFR and urinary protein excretion in T2DM patients with CKD stages 3b-4, but did not significantly reduce HbA1c. Further prospective clinical trials are warranted to fully elucidate the effects of SGLT2 inhibitors on glycemic control and renal function in T2DM patients with moderate-to-severe renal impairment.
机译：背景：对患有心血管疾病高风险的2型糖尿病（T2DM）患者的大型随机临床试验表明，钠-葡萄糖共转运蛋白2（SGLT2）抑制剂可显着减少肾脏事件。但是，该试验仅包括少数患有中度至重度慢性肾脏病（CKD）的患者。因此，SGLT2抑制剂的肾脏保护作用在伴有肾功能受损的T2DM患者中仍然未知。我们检查了SGLT2抑制剂是否对患有CKD的T2DM患者的肾脏功能产生了有益的影响。方法：我们回顾性研究了新加入SGLT2抑制剂新治疗且患有中度至重度肾功能不全的CKD 3b-4期的T2DM患者（15 <估计的肾小球滤过率（eGFR）<45 mL / min /在SGLT2抑制剂治疗开始时1.73 m 2 ）。我们分析了中度至重度肾功能不全的T2DM患者，他们继续使用SGLT2抑制剂至少一年。我们研究了SGLT2抑制剂治疗对治疗前后eGFR和尿蛋白排泄1年变化的影响。结果：我们分析了42例T2DM患者，其eGFR中位数为40.4 mL / min / 1.73 m 2 。一年的SGLT2抑制剂治疗将中位血红蛋白A1c（HbA1c）的水平从7.6％降至7.5％（不显着）。体重和血压显着降低，血红蛋白显着升高。 SGLT2抑制剂治疗1年后eGFR的中值为41.0 mL / min / 1.73 m 2 ，与基线相比无显着差异。 SGLT2抑制剂治疗后eGFR的年度下降显着改善（eGFR ：（中位数），前：-3.8，vs。后：每年0.1 mL / min / 1.73 m 2 ，P <0.01）。我们还发现，SGLT2抑制剂治疗后尿蛋白排泄量显着减少（尿蛋白与肌酐之比：（中位数），前：0.36，后：0.23 g / g肌酐，n = 35，P <0.01）。结论：这项研究揭示了有希望的观察结果，即SGLT2抑制剂的联合治疗发挥了显着的肾脏保护作用，最终使CKD 3b-4分期的T2DM患者的eGFR和尿蛋白排泄量逐年下降，但并未显着降低HbA1c。有必要进行进一步的前瞻性临床试验，以充分阐明SGLT2抑制剂对中重度肾功能不全的T2DM患者的血糖控制和肾功能的影响。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号