JASN:达格列净对4期慢性肾脏病的影响

2021-08-08 MedSci原创 MedSci原创

在4期CKD和蛋白尿患者中,达格列净的益处与DAPA-CKD试验中观察到的总体益处一致,没有证据表明其风险增加。

在达格列净和慢性肾脏病不良结局预防(DAPA-CKD)的随机安慰剂对照试验中,钠-葡萄糖协同转运蛋白2抑制剂达格列净显著降低了患有或不患有2型糖尿病的CKD患者的肾衰竭风险,并延长了患者生存期。


 
近日,肾脏病领域权威杂志Journal of the American Society of Nephrology上发表一篇研究文章,在这项针对4期CKD患者(eGFR<30mL/min/1.73m2)的达格列净疗效预设分析中,研究人员将eGFR为25-75mL/min/1.73m2和尿白蛋白-肌酐比为200-5000mg/g的成人随机分组接受10mg/天的达格列净或安慰剂治疗。

该研究的主要结局是eGFR持续下降≥50%、终末期肾脏疾病或肾脏或血管死亡的复合结局。次要结局为肾脏复合结局(与主要终点相同,但没有心血管死亡)、心血管死亡或心力衰竭住院复合结局以及全因死亡。

各结局累计发生率的生存曲线

 
该研究共有293名参与者接受了达格列净治疗,331名参与者接受了安慰剂治疗。相对于安慰剂,达格列净与主要复合结局(风险比[HR]为0.73;95%置信区间[95%CI]为0.53至1.0)、肾脏结局(HR为0.71;95%CI为0.49至1.02)、心血管结局(HR为0.83;95%CI为0.45至1.53)和死亡结局(HR为0.68;95%CI为0.39至1.21)相关。在达格列净和安慰剂组中,eGFR斜率每1.73平方米每年分别下降2.15和3.38 ml/min(P=0.005)。接受达格列净或安慰剂治疗的患者发生严重不良事件和感兴趣的不良事件发生率相似。
 
由此可见,在4期CKD和蛋白尿患者中,达格列净的益处与DAPA-CKD试验中观察到的总体益处一致,没有证据表明其风险增加。

原始出处:

Glenn Chertow,et al.Effects of Dapagliflozin in Stage 4 Chronic Kidney Disease.JASN,2021.https://jasn.asnjournals.org/content/early/2021/07/16/ASN.2021020167

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    2021-09-05 chenhongpeng
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    2021-08-08 smart Ren

    学习啦

    0

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    2021-08-08 ms812711744394816

    学习了

    0

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    2021-08-08 夜叶

    学习了

    0

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    2021-08-08 22583878

    好文

    0

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    2021-08-08 吃不到的果冻

    很有用谢谢

    0

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