Morioka Fumiyuki, Nakatani Shinya, Uedono Hideki, Tsuda Akihiro, Mori Katsuhito, Emoto Masanori
Department of Metabolism, Endocrinology and Molecular Medicine, Graduate School of Medicine, Osaka City University, Osaka 545-8585, Japan.
Department of Nephrology, Osaka Metropolitan University Graduate School of Medicine, Osaka 545-8585, Japan.
J Clin Med. 2023 Oct 3;12(19):6341. doi: 10.3390/jcm12196341.
Treatment with sodium-glucose cotransporter-2 (SGLT2) inhibitors may have pleiotropic and beneficial effects in terms of ameliorating of risk factors for the progression of autosomal dominant polycystic kidney disease (ADPKD). However, there is insufficient evidence regarding the use of these drugs in patients with ADPKD, as they were excluded from several clinical trials conducted to explore kidney protection provided by SGLT2 inhibitors. This retrospective single-arm case series study was performed to investigate the effects of dapagliflozin, a selective SGLT2 inhibitor administered at 10 mg/day, on changes in height-adjusted kidney volume (htTKV) and estimated glomerular filtration rate (eGFR) in ADPKD patients. During a period of 102 ± 20 days (range 70-156 days), eGFR was decreased from 47.9 (39.7-56.9) to 40.8 (33.7-44.5) mL/min/1.73 m ( < 0.001), while htTKV was increased from 599 (423-707) to 617 (446-827) mL/m ( = 0.002) (n = 20). The annual increase in htTKV rate was significantly promoted, and urinary phosphate change was found to be correlated with the change in htTKV (rs = 0.575, = 0.020). In the examined patients, eGFR was decreased and htTKV increased during short-term administration of dapagliflozin. To confirm the possibility of the effects of dapagliflozin on ADPKD, additional interventional studies are required.
用钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂进行治疗，在改善常染色体显性多囊肾病（ADPKD）进展的危险因素方面可能具有多效性和有益作用。然而，关于在ADPKD患者中使用这些药物的证据不足，因为在为探索SGLT2抑制剂提供的肾脏保护作用而开展的多项临床试验中，这些患者被排除在外。本项回顾性单臂病例系列研究旨在调查每日服用10mg选择性SGLT2抑制剂达格列净对ADPKD患者身高校正肾脏体积（htTKV）和估计肾小球滤过率（eGFR）变化的影响。在102±20天（范围70 - 156天）的时间段内，eGFR从47.9（范围39.7 - 56.9）降至40.8（范围33.7 - 44.5）mL/min/1.73m²（P<0.001），而htTKV从599（范围423 - 707）增至617（范围446 - 827）mL/m²（P = 0.002）（n = 20）。htTKV的年增长率显著提高，并且发现尿磷酸盐变化与htTKV变化相关（rs = 0.575，P = 0.020）。在所检查的患者中，短期服用达格列净期间eGFR下降而htTKV增加。为证实达格列净对ADPKD有作用的可能性，需要开展更多的干预性研究。
