open access

https://hdl.handle.net/2115/76296

Protective effect of sodium-glucose cotransporter 2 inhibitors in patients with rapid renal function decline, stage G3 or G4 chronic kidney disease and type 2 diabetes

英語

Sodium-glucose cotransporter 2 inhibitors inhibitor

2019-11

John Wiley & Sons

Journal of diabetes investigation

10(6)

1510-1517

Aims/Introduction The risk of end-stage kidney disease increases in proportion to the decline in the estimated glomerular filtration rate (eGFR). Although protective effects of sodium-glucose cotransporter 2 inhibitors (SGLT2i) on the eGFR decline were shown in several large-scale clinical trials, there are no studies investigating patients with a high risk of end-stage kidney disease. We investigated the efficacy and safety of SGLT2i in advanced renal dysfunction patients (stage G3 or G4 of chronic kidney disease) with a rapid decline in eGFR. Materials and Methods This retrospective, longitudinal study enrolled patients with type 2 diabetes who were treated with SGLT2i, and whose eGFR was 20% over 2 years (%Delta eGFR-2y) before initiating SGLT2i. The primary end-point was the change in eGFR 2 years after initiation (%Delta eGFR+2y) compared with %Delta eGFR-2y. Results A total of 17 patients among 553 patients treated with SGLT2i for >= 2 years were included in the study. The average age, glycated hemoglobin and eGFR at SGLT2i initiation were 68.5 years, 7.3% and 38.3 mL/min/1.73 m(2), respectively. %Delta eGFR+2y in patients who were treated with SGLT2i was significantly increased compared with the patients not treated with SGLT2i (2.3 and -21.7%, respectively; P < 0.0001). A multiple regression analysis showed that only the proportion of the rate of eGFR decline was the independent factor associated with improvement of %Delta eGFR+2y. There was no increase in serious adverse events including acute kidney injury. Conclusions SGLT2i was safe, and prevented further eGFR decline in patients with type 2 diabetes and advanced renal dysfunction.

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Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International

2040-1116