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达格列净对中重度慢性肾脏病患者尿酸的疗效。

Efficacy of dapagliflozin on uric acid in patients with moderate-to-severe chronic kidney disease.

作者信息

Yanai Katsunori, Hirai Keiji, Kitano Taisuke, Miyazawa Haruhisa, Ito Kiyonori, Ookawara Susumu, Morishita Yoshiyuki

机构信息

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.

出版信息

Clin Exp Nephrol. 2025 Sep 18. doi: 10.1007/s10157-025-02766-w.

Abstract

AIMS

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).

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.

摘要

目的

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。

方法

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。

结果

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。

结论

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。

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