Yanai Katsunori, Hirai Keiji, Kitano Taisuke, Miyazawa Haruhisa, Ito Kiyonori, Ookawara Susumu, Morishita Yoshiyuki
Division of Nephrology, First Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-Cho, Omiya-Ku, Saitama-Shi, Saitama-Ken, 330-8503, Japan.
Clin Exp Nephrol. 2025 Sep 18. doi: 10.1007/s10157-025-02766-w.
We investigated the efficacy of dapagliflozin, which is a sodium-glucose cotransporter 2 inhibitor, on uric acid (UA) in individuals with moderate-to-severe chronic kidney disease (CKD) (stage G3-4).
We retrospectively studied 46 patients (mean age: 66.6 ± 14.1 years; 32 men and 14 women) after 12 months of dapagliflozin treatment. We recorded the change in UA and urine protein. All of the patients had moderate-to-severe CKD (mean estimated glomerular filtration rate: 35.9 ± 10.9 mL/min/1.73 m; stage G3, n = 32; G4, n = 14). The data of 46 matched patients with similar propensity scores (who did not take dapagliflozin) were analyzed as a control group.
UA concentrations significantly decreased from baseline to 12 months in the dapagliflozin group (6.4 ± 1.2 mg/dL to 5.6 ± 1.4 mg/dL, probability (p) < 0.05) but UA concentrations did not change in the control group. In addition, UA concentrations were significantly lower in the dapagliflozin group than in the control group at 12 months (5.6 ± 1.4 mg/dL vs. 6.4 ± 1.4 mg/dL, p < 0.05). UA concentrations significantly decreased from baseline to 12 months in patients with CKD stage G3 in the dapagliflozin group at 12 months (6.4 ± 0.9 mg/dL to 5.4 ± 1.0 mg/dL, p < 0.05) but UA concentrations did not change in patients with CKD stage G4.
Dapagliflozin can decrease UA concentrations in patients with moderate CKD. This finding suggests that dapagliflozin has a beneficial effect on UA metabolism in patients with moderate CKD.
我们研究了钠-葡萄糖协同转运蛋白2抑制剂达格列净对中重度慢性肾脏病(CKD)(G3-4期)患者尿酸(UA)的影响。
我们对46例接受达格列净治疗12个月后的患者(平均年龄:66.6±14.1岁;男性32例,女性14例)进行了回顾性研究。我们记录了尿酸和尿蛋白的变化。所有患者均患有中重度CKD(平均估计肾小球滤过率:35.9±10.9 mL/min/1.73 m²;G3期,n = 32;G4期,n = 14)。将46例倾向评分相似(未服用达格列净)的匹配患者的数据作为对照组进行分析。
达格列净组的尿酸浓度从基线到12个月时显著降低(6.4±1.2 mg/dL降至5.6±1.4 mg/dL,概率(p)<0.05),但对照组的尿酸浓度没有变化。此外,达格列净组在12个月时的尿酸浓度显著低于对照组(5.6±1.4 mg/dL对6.4±1.4 mg/dL,p<0.05)。达格列净组中CKD G3期患者的尿酸浓度在12个月时从基线到12个月显著降低(6.4±0.9 mg/dL降至5.4±1.0 mg/dL,p<0.05),但CKD G4期患者的尿酸浓度没有变化。
达格列净可降低中度CKD患者的尿酸浓度。这一发现表明达格列净对中度CKD患者的尿酸代谢具有有益作用。