Lancet Diabetes Endo：SGLT2抑制剂的肾脏保护作用

2019-09-06 MedSci MedSci原创

SGLT 2抑制剂降低了II型糖尿病患者透析、移植或肾脏疾病死亡的风险，并对急性肾损伤提供了保护，上述数据为使用SGLT2抑制剂预防II型糖尿病患者的主要肾脏结局提供了实质性证据

钠-葡萄糖共转运体-2(SGLT2)抑制剂对肾功能衰竭，特别是透析、移植或肾脏疾病所致死亡的影响尚不确定。近日研究人员开展系统回顾和Meta分析，以评估SGLT2抑制剂对II型糖尿病患者主要肾功能的影响。

研究人员对截至2019年6月14日SGLT2抑制剂对心血管或肾脏结局试验进行了系统审查和荟萃分析，考察II型糖尿病患者主要肾脏结局，研究的主要结果是透析、移植或肾脏疾病造成的死亡。

4项研究纳入本次荟萃研究，评估了三种SGLT2抑制剂：Empagliflzin(EMPA-REG OUTCOME)、Canagliflzin(CANVAS和CREDENCE)和Dapagliflzin(DECLARE-TIMI 58)。在总共38723名参与者中，252人需要透析、移植或死于肾病，335人发展为终末期肾病，943人患有急性肾损伤。SGLT 2抑制剂可显著降低透析、移植或肾脏疾病死亡的风险(RR：0.67)，这一效应在研究中一致(I 2=0%)。SGLT 2抑制剂还可减少终末期肾病(0.65)和急性肾损伤(0.75)，且在研究中具有一致的疗效。虽然有证据表明SGLT2抑制剂的比例效应可能随着肾功能的下降而减弱，所有EGFR亚组都有明确的、单独的获益证据，包括基线eGFR 30-45 mL/min per 1.73 m 2 (RR： 0.70)。基线蛋白尿和RAS阻断的使用，对SGLT2抑制剂的肾保护无影响。

SGLT 2抑制剂降低了II型糖尿病患者透析、移植或肾脏疾病死亡的风险，并对急性肾损伤提供了保护，上述数据为使用SGLT2抑制剂预防II型糖尿病患者的主要肾脏结局提供了实质性证据。

原始出处：

Brendon L Neuen et al. SGLT2 inhibitors for the prevention of kidney failure in patients with type 2 diabetes： a systematic review and meta-analysis. Lancet Diabetes Endo. September 05， 2019.

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2020-02-04 ms5439512287675881

#BET#

59 0
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2020-04-10 tulenzi

#SGLT#

50 0
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2020-03-10 howi

#Lancet#

46 0
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2020-06-30 jklm09

#抑制剂#

55 0
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2020-04-23 木头人513

#Diabetes#

47 0
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2020-07-15 ms9608593228839890

#DIA#

68 0
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2019-11-30 liuquan

#2抑制剂#

56 0
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2019-09-08 jiekemin

#SGLT2#

61 0
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2019-09-08 photoman

#保护作用#

58 0

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Lancet Diabetes Endo：SGLT2抑制剂的肾脏保护作用

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