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钠-葡萄糖协同转运蛋白2抑制剂(SGLT2Is)对慢性肾脏病(CKD)患者勃起功能障碍(ED)的影响。

Sodium glucose co-transporter 2 inhibitors (SGLT2Is) effect on erectile dysfunction (ED) in patients with chronic kidney disease (CKD).

作者信息

Shaker Amr Mohamed, Rakha Nehal Kamal, Keshk Ahmed, El Din Usama A Sharaf

机构信息

Nephrology Unit, Internal Medicine Department, Faculty of Medicine, Cairo University, Giza, Egypt.

Andrology Department, Faculty of Medicine, Cairo University, Giza, Egypt.

出版信息

Clin Exp Nephrol. 2025 Sep 3. doi: 10.1007/s10157-025-02757-x.

Abstract

BACKGROUND

ED is commonly encountered among male CKD patients. SGLT2Is were recently recommended as a universal treatment for CKD. It's hypothesized that the mechanism of action of SGLT2Is could be related to improving endothelial dysfunction. So, patients with ED due to CKD might benefit from adding SGLT2Is to their management. We aimed to study the effect of SGLT2Is on ED in CKD patients.

METHODS

After complete clinical examination and laboratory investigations needed to exclude other causes of ED, 34 CKD cases were randomly assigned to receive either empagliflozin (Empa) or dapagliflozin (Dapa). All selected candidates signed a written consent and were then referred to the Andrology clinic for assessment for ED. The structured questionnaire (International Index of Erectile Function) was used before starting and 3 months after use of the assigned SGLT2I.

RESULTS

Both SGLT2Is were associated with highly significant improvement in kidney function as well as IIEF-5 (P < 0.001 in all).

CONCLUSION

SGLT2Is improve endothelial function and correct pericyte depletion induced by uremia. The postulated mechanisms of action that improve erectile function are discussed.

摘要

背景

勃起功能障碍(ED)在男性慢性肾脏病(CKD)患者中较为常见。钠-葡萄糖协同转运蛋白2抑制剂(SGLT2Is)最近被推荐作为CKD的通用治疗方法。据推测,SGLT2Is的作用机制可能与改善内皮功能障碍有关。因此,因CKD导致ED的患者可能会从在其治疗方案中添加SGLT2Is中获益。我们旨在研究SGLT2Is对CKD患者ED的影响。

方法

在完成排除ED其他病因所需的全面临床检查和实验室检查后,34例CKD患者被随机分配接受恩格列净(Empa)或达格列净(Dapa)治疗。所有入选患者均签署书面知情同意书,然后被转至男科门诊进行ED评估。在开始使用指定的SGLT2I之前和使用3个月后使用结构化问卷(国际勃起功能指数)。

结果

两种SGLT2Is均与肾功能以及国际勃起功能指数-5(IIEF-5)的高度显著改善相关(所有P均<0.001)。

结论

SGLT2Is可改善内皮功能并纠正尿毒症诱导的周细胞耗竭。讨论了改善勃起功能的假定作用机制。

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