钠-葡萄糖协同转运蛋白2抑制剂在移植前患有2型糖尿病的肾移植受者中的安全性和有效性：一项对85例移植患者的回顾性、单中心、治疗权重逆概率分析
Safety and Efficacy of Sodium-glucose Cotransporter 2 Inhibitors in Kidney Transplant Recipients With Pretransplant Type 2 Diabetes Mellitus: A Retrospective, Single-center, Inverse Probability of Treatment Weighting Analysis of 85 Transplant Patients.
作者信息
Hisadome Yu, Mei Takanori, Noguchi Hiroshi, Ohkuma Toshiaki, Sato Yu, Kaku Keizo, Okabe Yasuhiro, Nakamura Masafumi
机构信息
Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
出版信息
Transplant Direct. 2021 Oct 6;7(11):e772. doi: 10.1097/TXD.0000000000001228. eCollection 2021 Nov.
UNLABELLED
Whether sodium-glucose cotransporter 2 (SGLT2) inhibitors can be used effectively and safely in kidney transplant (KT) recipients with pretransplant type 2 diabetes as the primary cause of end-stage renal disease (ESRD) remains unclear. In this study, we retrospectively analyzed the efficacy and safety of SGLT2 inhibitors compared with other oral hypoglycemic agents (OHAs) in KT recipients with pretransplant type 2 diabetes as the primary cause of ESRD.
METHODS
In this retrospective, observational, single-center, inverse probability of treatment weighting (IPTW) analysis study, we compared the outcomes of SGLT2 inhibitors (SGLT2 group) and other OHAs (control group) following KT. A total of 85 recipients with type 2 diabetic nephropathy as the major cause of ESRD before KT who were treated at our institute between October 2003 and October 2019 were screened and included. The variables considered for IPTW were recipient age, sex, body mass index, history of cardiovascular disease, ABO incompatibility, insulin therapy, estimated glomerular filtration rate (eGFR), and hemoglobin A1c (HbA1c) at the initiation of additional OHAs. Primary endpoints were changes in HbA1c, body weight, and eGFR 1 y after the initiation of additional OHAs.
RESULTS
After IPTW analysis, there were 26 patients in the SGLT2 group and 59 patients in the control group (n = 85 overall). The body weights were significantly reduced in the SGLT2 group. There was no statistical difference in changes in HbA1c and eGFR. Similarly, there was no significant difference in the incidence of urinary infection, acute rejection, or other side effects between the groups.
CONCLUSIONS
Our findings suggested that SGLT2 inhibitors reduced the body weight of KT recipients and were used safely without increasing side effects.
未标注
钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂能否有效且安全地安全安全地用于以移植前2型糖尿病作为终末期肾病（ESRD）主要病因的肾移植（KT）受者，目前尚不清楚。在本研究中，我们回顾性分析了SGLT2抑制剂与其他口服降糖药（OHA）相比，在以移植前2型糖尿病作为ESRD主要病因的KT受者中的疗效和安全性。
方法
在这项回顾性、观察性、单中心、治疗权重逆概率（IPTW）分析研究中，我们比较了KT后SGLT2抑制剂组（SGLT2组）和其他OHA组（对照组）的结局。筛选并纳入了2003年10月至2019年10月在我们研究所接受治疗的85例在KT前以2型糖尿病肾病作为ESRD主要病因的受者。IPTW考虑的变量包括受者年龄、性别、体重指数、心血管疾病史、ABO血型不相容性、胰岛素治疗、额外OHA起始时的估计肾小球滤过率（eGFR）和糖化血红蛋白（HbA1c）。主要终点是额外OHA起始后1年时HbA1c、体重和eGFR的变化。
结果
经过IPTW分析，SGLT2组有26例患者，对照组有59例患者（共85例）。SGLT2组体重显著降低。HbA1c和eGFR的变化无统计学差异。同样，两组间尿路感染、急性排斥或其他副作用的发生率也无显著差异。
结论
我们的研究结果表明，SGLT2抑制剂可降低KT受者的体重，且使用安全，不会增加副作用。
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