钠-葡萄糖协同转运蛋白2抑制剂对接受经皮介入治疗的2型糖尿病合并冠状动脉疾病患者肾功能的影响：一项系统评价和荟萃分析

Impact of SGLT2 Inhibitors on Renal Function in Type 2 Diabetic Patients with Coronary Artery Disease Undergoing Percutaneous Intervention: A Systematic Review and Meta-Analysis.

作者信息

Basutkar Roopa Satyanarayan, Cutinha Rasheal Maria, Sathish Varshini, Shahil Aboobacker, Saneen C K Najad

机构信息

Department of Pharmacy Practice, Nitte (Deemed to be University), NGSM Institute of Pharmaceutical Sciences (NGSMIPS), Mangalore, Karnataka, India.

出版信息

Curr Diabetes Rev. 2025;21(9):e030724231535. doi: 10.2174/0115733998301228240625065230.

DOI:10.2174/0115733998301228240625065230

PMID:38963097

Abstract

BACKGROUND

Contrast agents directly cause kidney toxicity in patients who are candidates for percutaneous intervention having cardiovascular disease with type 2 diabetes.

AIMS

This meta-analysis aims to assess the effects of SGLT2i on renal function in individuals undergoing percutaneous intervention.

METHODS

The databases used for the search included Google Scholar, PubMed, Cochrane Central Registry of Controlled Trials, and Scopus. We considered randomized controlled and observational studies published from January, 2013, to August, 2023. Eligibility to include the studies was assessed independently. The Cochrane modified data extraction form and Joanna Briggs Institute were used to extract the data. The quality of the studies was evaluated using the Cochrane risk of bias tool and the Newcastle-Ottawa scale. The GradePro software was used to measure the certainty of the evidence.

RESULTS

The pooled estimate showed a substantial reduction in serum creatinine levels at 48 and 72 hours post-PCI who received SGLT2i (MD -9.57; 95% CI -18.36, -0.78; p-value 0.03 and MD - 14.40; 95% CI -28.57, -0.22; p-value 0.05). There was a decrease in the occurrence of the CI-AKI among SGT2i users (RR: 0.46; 95% CI: 0.32, 0.67; p value< 0.0001). No substantial difference was observed in the number of patients requiring hemodialysis; however, a lower proportion of patients among SGLT2i users required hemodialysis (RR: 0.88; 95% CI: 0.19, 4.07; p-value = 0.87).

CONCLUSION

The use of SGLT2i confers substantial beneficial effects on kidney function and reduces the occurrence of contrast-induced acute kidney injury among diabetes patients undergoing PCI procedures with cardiovascular disease.

摘要

背景

造影剂会直接导致患有2型糖尿病的心血管疾病患者在接受经皮介入治疗时出现肾脏毒性。

目的

本荟萃分析旨在评估钠-葡萄糖协同转运蛋白2抑制剂（SGLT2i）对接受经皮介入治疗个体肾功能的影响。

方法

用于检索的数据库包括谷歌学术、PubMed、Cochrane对照试验中央注册库和Scopus。我们纳入了2013年1月至2023年8月发表的随机对照研究和观察性研究。独立评估纳入研究的资格。使用Cochrane修改后的数据提取表和乔安娜·布里格斯循证卫生保健中心的数据提取表来提取数据。使用Cochrane偏倚风险工具和纽卡斯尔-渥太华量表评估研究质量。使用GradePro软件衡量证据的确定性。

结果

汇总估计显示，接受SGLT2i治疗的患者在PCI术后48小时和72小时时血清肌酐水平大幅降低（MD -9.57；95%CI -18.36，-0.78；p值0.03；MD -14.40；95%CI -28.57，-0.22；p值0.05）。SGLT2i使用者中造影剂所致急性肾损伤（CI-AKI）的发生率有所降低（RR：0.46；95%CI：0.32，0.67；p值<0.0001）。在需要进行血液透析的患者数量上未观察到显著差异；然而，SGLT2i使用者中需要血液透析的患者比例较低（RR：0.88；95%CI：0.19，4.07；p值 = 0.87）。