Xiao Xiang, Ji Shuming, Zheng Tao, Wang Tianzhu, Jiang Dapeng, Liu Fang
Division of Nephrology, West China Hospital of Sichuan University, Chengdu, China.
Department of Nephrology, The first affiliated hospital of Chengdu Medical college, Chengdu, China.
Front Pharmacol. 2024 Dec 3;15:1468435. doi: 10.3389/fphar.2024.1468435. eCollection 2024.
This study aimed to investigate the association between the utilization of Sodium-dependent glucose cotransporters inhibitors (SGLT2i) in real-world settings and kidney outcomes in patients with type 2 diabetes (T2D) and chronic kidney disease (CKD) in mainland China.
In a retrospective analysis of electronic medical records from West China Hospital of Sichuan University, patients with T2D and CKD were included. Patients were divided into two groups, those initiating treatment with SGLT2i and those receiving other glucose-lowering drugs (oGLDs). The primary focus lies in examining the impact of SGLT2i on the decline slope of eGFR and major kidney events in these patients.
We enrolled 944 patients diagnosed with both T2D and CKD. Out of these, 605 patients were prescribed SGLT2i, while the remaining 339 patients received oGLDs. The median follow-up duration were 16.8 months and 20.6 months, respectively. Throughout the follow-up period, we observed a significant decrease in the rate of eGFR decline in patients using SGLT2i (4.94 mL/min/1.73 m per year reduction compared to oGLDs, 95% CI: 4.73-5.15). A total of 101 kidney composite endpoint events occurred, with 31 events in the SGLT2i group and 70 events in the oGLDs group. The use of SGLT2i was associated with a 65% decrease in the risk of kidney composite endpoint events (hazard ratio 0.35, 95% CI 0.19-0.63).
In clinical practice, SGLT2i have shown favorable effects on kidney prognosis in patients with T2D and CKD in mainland China. These effects remain consistent across patients with varying risks of CKD progression.
ChiCTR2300068497.
本研究旨在探讨中国大陆2型糖尿病（T2D）合并慢性肾脏病（CKD）患者在实际临床环境中使用钠-葡萄糖协同转运蛋白2抑制剂（SGLT2i）与肾脏结局之间的关联。
在对四川大学华西医院电子病历的回顾性分析中，纳入了T2D合并CKD患者。患者被分为两组，一组开始使用SGLT2i治疗，另一组接受其他降糖药物（oGLDs）治疗。主要关注SGLT2i对这些患者估算肾小球滤过率（eGFR）下降斜率和主要肾脏事件的影响。
我们纳入了944例诊断为T2D合并CKD的患者。其中，605例患者使用SGLT2i，其余339例患者接受oGLDs治疗。中位随访时间分别为16.8个月和20.6个月。在整个随访期间，我们观察到使用SGLT2i的患者eGFR下降速率显著降低（与oGLDs相比，每年降低4.94 mL/min/1.73m²，95%CI：4.73-5.15）。共发生101例肾脏复合终点事件，其中SGLT2i组31例，oGLDs组70例。使用SGLT2i与肾脏复合终点事件风险降低65%相关（风险比0.35，95%CI 0.19-0.63）。
在临床实践中，SGLT2i对中国大陆T2D合并CKD患者的肾脏预后显示出有益效果。这些效果在不同CKD进展风险的患者中保持一致。
ChiCTR2300068497。
