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钠-葡萄糖共转运蛋白 2 抑制剂在非糖尿病慢性肾脏病患者中的应用:系统评价。

Sodium-Glucose Cotransporter-2 Inhibitors in Patients with Non-diabetic Chronic Kidney Disease: A Systematic Review.

机构信息

Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

Iran J Kidney Dis. 2023 Jul;17(4):175-183.

Abstract

Sodium-glucose cotransporter-2 (SGLT2) inhibitors modulate kidney function in diabetic chronic kidney disease trials. Furthermore, recent studies have showed their effect on kidney dysfunction in non-diabetic chronic kidney disease (CKD). Here, we focus on the impact of SGLT2 inhibitors on some renal parameters in nondiabetic CKD by discussing completed and ongoing trials. Different databases and search engines of Web of Science, PubMed, Google Scholar, Scopus, SID, and Magiran were searched until November 2022. We included human studies that evaluated the effect of SGLT2 inhibitors in non-diabetic CKD participants. Two authors independently screened the articles for inclusion, extracted the data, and assessed the quality of the included studies. The primary outcomes were the effect of the SGLT2 inhibitors on proteinuria, GFR and blood pressure. A total of 46 full texts were assessed for eligibility, and further review. After reviewing the full texts, seven eligible articles were entered included in this study. We suggest that SGLT2 inhibitors provide renal protection by modifying predisposing factors in the development of CKD, specifically albuminuria and GFR decrease. Other beneficial effects of these agents on blood pressure and sympathetic nerve activity might be considered as a possible mechanism for improving renal hemodynamics. We believe SGLT2 inhibitors could be considered as an effective add-on therapy in non-diabetic CKD patients.  DOI: 10.52547/ijkd.7309.

摘要

钠-葡萄糖共转运蛋白 2(SGLT2)抑制剂在糖尿病慢性肾脏病试验中调节肾脏功能。此外,最近的研究表明它们对非糖尿病慢性肾脏病(CKD)的肾功能障碍也有影响。在这里,我们通过讨论已完成和正在进行的试验,重点关注 SGLT2 抑制剂对非糖尿病 CKD 中某些肾脏参数的影响。我们在 2022 年 11 月之前在 Web of Science、PubMed、Google Scholar、Scopus、SID 和 Magiran 的不同数据库和搜索引擎中进行了搜索。我们纳入了评估 SGLT2 抑制剂对非糖尿病 CKD 参与者影响的人类研究。两位作者独立筛选文章以纳入、提取数据并评估纳入研究的质量。主要结局是 SGLT2 抑制剂对蛋白尿、肾小球滤过率(GFR)和血压的影响。总共评估了 46 篇全文的入选资格,并进行了进一步审查。在审查全文后,有 7 篇符合条件的文章被纳入本研究。我们认为,SGLT2 抑制剂通过改变 CKD 发展的易患因素(特别是白蛋白尿和 GFR 下降)来提供肾脏保护。这些药物对血压和交感神经活性的其他有益影响可能被认为是改善肾脏血液动力学的一种可能机制。我们相信 SGLT2 抑制剂可以被认为是非糖尿病 CKD 患者的有效附加治疗。DOI:10.52547/ijkd.7309.

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