Gilani Syedah Fauzia Fatima, Ali Shabana, Siddique Muhammad Bilal, Farhat Kulsoom, Noor Mudassar, Waqar Farzana
Syedah Fauzia Fatima Gilani, MBBS, MPhil, Pharmacology Department, Army Medical College, Rawalpindi, Pakistan.
Shabana Ali, MBBS, MPhil, FCPS, Pharmacology Department, Army Medical College, Rawalpindi, Pakistan.
Pak J Med Sci. 2023 Nov-Dec;39(6):1695-1700. doi: 10.12669/pjms.39.6.7525.
To evaluate the influence of dapagliflozin on renal functions and diuretics use in patients with acute heart failure (AHF).
This comparative analytical study was conducted at Armed Forces Institute of Cardiology, Rawalpindi from July 2022 to November 2022. Patients were distributed equally in two groups i.e. Dapagliflozin and Conventional Groups, where patients received dapagliflozin added to conventional therapy for AHF and, only conventional therapy for AHF respectively. Estimated glomerular filtration rate (eGFR), serum creatinine were measured and compared on admission, after 48 hours and on discharge. Weight loss during hospitalization, daily dose of furosemide and length of hospital stay was also recorded. Quantitative parameters were analyzed using t-test or Mann Whitney U test accordingly.
There were no significant baseline differences in renal functions. A modest decline in eGFR was observed in both groups after 48 hours. However, the variation in values of eGFR remained similar among both groups after 48 hours -value 0.365) and on discharge (-value 0.768). Whereas, patients subjected to dapagliflozin treatment exhibited a more profound diuretic response expressed as greater weight loss (-value < 0.001), achieved at comparatively lower doses of loop diuretics. Moreover, they also had a shorter duration of hospital stay (six vs eight days, -value <0.001).
Institution of dapagliflozin did not cause any significant deterioration of renal functions, whereas; it was associated with improved diuretic response as depicted by more pronounced weight loss at comparatively lower doses of loop diuretics.
评估达格列净对急性心力衰竭(AHF)患者肾功能及利尿剂使用情况的影响。
本比较分析研究于2022年7月至2022年11月在拉瓦尔品第武装部队心脏病学研究所进行。患者被平均分为两组,即达格列净组和常规治疗组,达格列净组患者在AHF常规治疗基础上加用达格列净,常规治疗组患者仅接受AHF常规治疗。分别在入院时、48小时后及出院时测量并比较估算肾小球滤过率(eGFR)、血清肌酐水平。记录住院期间体重减轻情况、呋塞米每日剂量及住院时长。定量参数分别采用t检验或曼-惠特尼U检验进行分析。
两组患者肾功能的基线水平无显著差异。48小时后两组患者的eGFR均出现适度下降。然而,48小时后(P值为0.365)及出院时(P值为0.768),两组患者的eGFR值变化相似。此外,接受达格列净治疗的患者利尿反应更为显著,表现为体重减轻更明显(P值<0.001),且在相对较低剂量的襻利尿剂作用下即可实现。此外,这些患者的住院时间也较短(分别为6天和8天,P值<0.001)。
应用达格列净并未导致肾功能出现任何显著恶化;相反,在相对较低剂量的襻利尿剂作用下,达格列净可使体重减轻更为明显,显示出其与利尿反应改善相关。