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慢性肾脏病患者(无论是否接受肾移植)使用钠-葡萄糖协同转运蛋白2抑制剂——一项单中心研究

The sodium-glucose cotransporter-2 inhibitors in patients with chronic kidney disease with or without kidney transplantation - a single centre study.

作者信息

Kleinova Patricia, Granak Karol, Vnucak Matej, Beliancinova Monika, Blichova Timea, Dedinska Ivana

出版信息

Bratisl Lek Listy. 2024;125(12):759-765. doi: 10.4149/BLL_2024_116.

Abstract

INTRODUCTION

The sodium-glucose cotransporter-2 inhibitors (SGLT2i) represent the first-line treatment for chronic kidney disease. The question remains of their benefit and safety for patients after kidney transplantation. The study aimed to show the renoprotective effect and safety of use in patients with chronic kidney disease with or without kidney transplantation.

MATERIAL

This is a prospective monocentric study of the Transplant-Nephrology Department in Martin in which patients with chronic kidney disease with or without kidney transplant in therapy with dapagliflozin were included (n=79). The changes in glomerular filtration rate, albuminuria and side effects associated with SGLT2i were studied in patients with chronic kidney disease with or without kidney transplantation and in patients with or without diabetes mellitus.

RESULTS

Patients without diabetes mellitus achieved a significantly higher decrease in albuminuria at the time of the third month of follow-up (p=0.0396), with the continuation of the decrease until the average follow-up (10.9 months) (p=0.7866) than patients with diabetes mellitus. During the observed period, we recorded the cessation of the primary decrease in glomerular filtration with a return to the baseline values. In our group, we did not confirm a significant occurrence of adverse effects associated with dapagliflozin.

CONCLUSION

SGLT2i significantly reduces albuminuria and stabilizes glomerular filtration in patients with chronic kidney disease. Based on our analysis, treatment with gliflozins is effective and safe for patients after kidney transplantation (Tab. 4, Fig. 6, Ref. 16).

摘要

引言

钠-葡萄糖协同转运蛋白2抑制剂(SGLT2i)是慢性肾脏病的一线治疗药物。对于肾移植术后患者,其益处和安全性仍存在疑问。本研究旨在证明SGLT2i在有或无肾移植的慢性肾脏病患者中使用的肾脏保护作用和安全性。

材料

这是一项在马丁市移植肾脏病科进行的前瞻性单中心研究,纳入了接受达格列净治疗的有或无肾移植的慢性肾脏病患者(n = 79)。研究了有或无肾移植以及有或无糖尿病的慢性肾脏病患者的肾小球滤过率、蛋白尿变化以及与SGLT2i相关的副作用。

结果

在随访第三个月时,无糖尿病的患者蛋白尿下降幅度显著更高(p = 0.0396),且在平均随访期(10.9个月)内持续下降(p = 0.7866),高于糖尿病患者。在观察期内,我们记录到肾小球滤过率的初始下降停止,恢复到基线值。在我们的研究组中,未证实与达格列净相关的不良反应有显著发生。

结论

SGLT2i可显著降低慢性肾脏病患者的蛋白尿并稳定肾小球滤过率。根据我们的分析,格列净类药物治疗对肾移植术后患者有效且安全(表4,图6,参考文献16)。

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