Department of Nephrology, Hospital General Universitario de Ciudad Real, 13005 Ciudad Real, Spain.
Department of Nephrology, Hospital Central de la Defensa Gómez Ulla, 28047 Madrid, Spain.
Medicina (Kaunas). 2024 Jul 24;60(8):1198. doi: 10.3390/medicina60081198.
: Peritoneal dialysis (PD) is a renal replacement therapy modality in which the dialysis dose can be individually adapted according to the patients' residual kidney function (RKF). RKF is a crucial factor for technique and patient survival. Pharmacological strategies aimed at slowing the loss of RKF in patients on PD are limited. Therefore, we aimed to assess the potential effects and safety of sodium-glucose cotransporter 2 (SGLT-2) inhibitors on the preservation of RKF in patients with and without type 2 diabetes mellitus (T2DM) on PD during an average follow-up of 6 months. : In this retrospective observational, single-center study on real-world data, we included patients from the Peritoneal Dialysis Unit of the Hospital General Universitario de Ciudad Real, who started treatment with SGLT-2 inhibitors during the period from December 2022 to December 2023. Data on analytical and clinical parameters, RKF, and peritoneal membrane transport function were retrospectively collected at months 0, 3, and 6. : Out of 31 patients in our unit, 16 prevalent patients initiated treatment with SGLT-2 inhibitors (13 empagliflozin and 3 dapagliflozin). A total of 62.5% were male and the mean age was 67.3 years. The baseline peritoneal ultrafiltration was higher in the non-diabetic patient (NDMP) group than in the diabetic patient (DMP) group. However, the residual diuresis volume, 24 h residual renal clearance rate of urea in urine, and 24 h proteinuria were higher in the DMP group than in the NDMP group. At the sixth month, patients in both groups preserved RKF and diuresis, with a trend towards a non-significant reduction in proteinuria and blood pressure. Only two patients of the DMP group presented adverse effects. : The use of SGLT-2 inhibitors in our sample of patients with and without T2DM on PD appears to be safe and effective to preserve RKF.
腹膜透析（PD）是一种肾脏替代治疗方式，其中透析剂量可以根据患者的残余肾功能（RKF）进行个体化调整。RKF 是技术和患者生存的关键因素。目前，旨在减缓 PD 患者 RKF 丧失的药物治疗策略有限。因此，我们旨在评估钠-葡萄糖共转运蛋白 2（SGLT-2）抑制剂在平均随访 6 个月期间对 PD 合并和不合并 2 型糖尿病（T2DM）患者 RKF 保护的潜在作用和安全性。
在这项回顾性观察性、单中心真实世界研究中，我们纳入了 2022 年 12 月至 2023 年 12 月期间在 Ciudad Real 综合医院腹膜透析科开始接受 SGLT-2 抑制剂治疗的患者。回顾性收集了 0、3 和 6 个月时的分析和临床参数、RKF 和腹膜膜转运功能数据。
在我们的科室中，有 31 名患者，其中 16 名患者开始接受 SGLT-2 抑制剂治疗（13 名患者使用恩格列净，3 名患者使用达格列净）。其中，62.5%为男性，平均年龄为 67.3 岁。非糖尿病患者（NDMP）组的基础腹膜超滤量高于糖尿病患者（DMP）组。然而，DMP 组的残余尿量、24 小时尿尿素清除率和 24 小时蛋白尿较高。在第六个月，两组患者均保留了 RKF 和尿量，且蛋白尿和血压呈下降趋势，但无统计学意义。DMP 组仅 2 例患者出现不良反应。
在我们的 PD 合并和不合并 T2DM 患者样本中，使用 SGLT-2 抑制剂似乎是安全有效的，可以保留 RKF。
