Nephrology Department, Kidney and Urology Center, Alexandria, Egypt.
Nephrology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Eur J Clin Pharmacol. 2023 Jul;79(7):961-966. doi: 10.1007/s00228-023-03508-1. Epub 2023 May 18.
Despite the known effects of sodium-glucose-cotransporter 2 (SGLT2) inhibitors in halting chronic kidney disease (CKD) progression and decreasing mortality from renal and cardiovascular causes, their use in patients with primary and secondary glomerular diseases maintained on immunosuppressive therapies (IST) has not yet been established.
In this open-label, uncontrolled study, SGLT2 inhibitors were prescribed to patients with glomerular diseases maintained on IST to assess the safety of their use.
Nine out of 17 patients had no diabetes. During a mean of 7.3 months follow-up duration, the incidence rate of urinary tract infection (UTI) was 1.6 per 100 person-months. The UTI episodes were successfully treated with antibiotic therapy without the need to discontinue SGLT2 inhibitors. There were no cases of acute kidney injury (AKI), ketoacidosis, amputation, or Fournier gangrene. Moreover, markers of kidney damage such as mean serum creatinine (decreased from 1.7 to 1.37 mg/dl) and mean proteinuria (urinary albumin-to-creatinine ratio decreased from 2669 to 858 mg/g) improved throughout the follow-up period.
SGLT2i are safe to use in patients with glomerular diseases on IST.
尽管钠-葡萄糖共转运蛋白 2（SGLT2）抑制剂已被证实可阻止慢性肾脏病（CKD）进展并降低因肾脏和心血管原因导致的死亡率，但在接受免疫抑制治疗（IST）的原发性和继发性肾小球疾病患者中，其应用尚未得到证实。
在这项开放标签、非对照研究中，给接受 IST 的肾小球疾病患者开了 SGLT2 抑制剂，以评估其使用安全性。
17 名患者中有 9 名无糖尿病。在平均 7.3 个月的随访期间，尿路感染（UTI）的发病率为每 100 人-月 1.6 例。UTI 发作经抗生素治疗成功治愈，无需停用 SGLT2 抑制剂。无急性肾损伤（AKI）、酮症酸中毒、截肢或 Fournier 坏疽病例。此外，整个随访期间，肾脏损伤标志物如血清肌酐均值（从 1.7 降至 1.37mg/dl）和蛋白尿均值（尿白蛋白/肌酐比值从 2669 降至 858mg/g）均有所改善。
SGLT2i 在接受 IST 的肾小球疾病患者中使用是安全的。
