SGLT2i对糖尿病肾病治疗获益共识 2020

2020-10-13 孟加拉国内分泌协会(Endocrine Society of Bengal) Diabetes Ther . 2020 Oct 6. doi: 10.1007/s13300-020-00921-y.

糖尿病肾病(DKD)发生在大约20-40%的2型糖尿病患者中。 DKD患者罹患心血管疾病和全因死亡率的风险更高。血管紧张素转换酶抑制剂或血管紧张素受体阻滞剂和降糖药是DKD管理的主要内容,旨在限制病情

中文标题:

SGLT2i对糖尿病肾病治疗获益共识 2020

英文标题:

Kidney Disease in Type 2 Diabetes Mellitus and Benefits of Sodium-Glucose Cotransporter 2 Inhibitors: A Consensus Statement

发布日期:

2020-10-13

简要介绍:

糖尿病肾病(DKD)发生在大约20-40%的2型糖尿病患者中。 DKD患者罹患心血管疾病和全因死亡率的风险更高。血管紧张素转换酶抑制剂或血管紧张素受体阻滞剂和降糖药是DKD管理的主要内容,旨在限制病情发展至更严重的DKD阶段。钠葡萄糖共转运蛋白2抑制剂(SGLT2i)除了阻止炎症外,还通过阻断肾脏对葡萄糖的重吸收来控制高血糖症,从而改善内皮功能并减少氧化应激。因此,这类处方药正在作为治疗性武器库的重要补充而出现。 EMPA-REG结果,DECLARE TIMI 58和CANVAS试验证明了SGLT2i的肾脏保护作用,例如限制肾小球滤过率的下降,白蛋白尿的进展以及由于肾病引起的死亡。 SGLT2i提供的肾脏保护作用在CREDENCE研究中得到进一步证实,该研究表明慢性肾脏疾病的进展减少了30%;在DELIGHT研究中,与安慰剂相比,达格列净治疗组的蛋白尿减少了(-21.0%,置信区间[CI]-34.1至-5.2,p = 0.011)。此外,荟萃分析显示,由于肾脏疾病而导致透析,移植或死亡的风险降低(相对风险0.67; 95%CI 0.52-0.86; p = 0.0019),并且肾功能恶化的风险降低了45%,最终基线估计的肾小球滤过率,伴有SGLT2i的晚期肾病或肾死亡(危险比0.55,CI 0.48-0.64,p <0.0001)。因此,新出现的证据表明,SGLT2i可用于降低DKD患者的死亡率并改善其生活质量。但是,临床医生需要有效地选择SGLT2i治疗的候选人。在这份共识性声明中,我们获得了定性综合的证据,证明了SGLT2i的肾脏作用,并提出了关于最佳使用SGLT2i来有效管理和延缓DKD进展的建议。

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1067035, encodeId=4eef106e0357e, content=好, beContent=null, objectType=guider, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ef2c1960942, createdName=1e1366a1m07(暂无匿称), createdTime=Thu Nov 04 20:37:10 CST 2021, time=2021-11-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1061046, encodeId=731c106104662, content=<a href='/topic/show?id=4f77e665253' target=_blank style='color:#2F92EE;'>#糖尿病#</a>学习, beContent=null, objectType=guider, channel=null, level=null, likeNumber=119, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76652, encryptionId=4f77e665253, topicName=糖尿病)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210717/d2cb4857e66b463b9f7e61b63bbf19ea/95f23f544c0c40a7b9fc5cea7816f727.jpg, createdBy=140f1737581, createdName=lotus~, createdTime=Sat Oct 16 14:45:15 CST 2021, time=2021-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1051723, encodeId=ec8f1051e2337, content=值得学习, beContent=null, objectType=guider, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6c905475903, createdName=湘雅科教, createdTime=Thu Sep 16 00:04:59 CST 2021, time=2021-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=920133, encodeId=853f920133d1, content=想看, beContent=null, objectType=guider, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ab255454717, createdName=ms3000001967035392, createdTime=Tue Jan 26 22:43:32 CST 2021, time=2021-01-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=906958, encodeId=3b50906958a6, content=很需要这方面的知识。, beContent=null, objectType=guider, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=88d75443426, createdName=chen20201211, createdTime=Fri Dec 11 09:20:36 CST 2020, time=2020-12-11, status=1, ipAttribution=)]
    2021-10-16 lotus~
  3. [GetPortalCommentsPageByObjectIdResponse(id=1067035, encodeId=4eef106e0357e, content=好, beContent=null, objectType=guider, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ef2c1960942, createdName=1e1366a1m07(暂无匿称), createdTime=Thu Nov 04 20:37:10 CST 2021, time=2021-11-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1061046, encodeId=731c106104662, content=<a href='/topic/show?id=4f77e665253' target=_blank style='color:#2F92EE;'>#糖尿病#</a>学习, beContent=null, objectType=guider, channel=null, level=null, likeNumber=119, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76652, encryptionId=4f77e665253, topicName=糖尿病)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210717/d2cb4857e66b463b9f7e61b63bbf19ea/95f23f544c0c40a7b9fc5cea7816f727.jpg, createdBy=140f1737581, createdName=lotus~, createdTime=Sat Oct 16 14:45:15 CST 2021, time=2021-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1051723, encodeId=ec8f1051e2337, content=值得学习, beContent=null, objectType=guider, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6c905475903, createdName=湘雅科教, createdTime=Thu Sep 16 00:04:59 CST 2021, time=2021-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=920133, encodeId=853f920133d1, content=想看, beContent=null, objectType=guider, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ab255454717, createdName=ms3000001967035392, createdTime=Tue Jan 26 22:43:32 CST 2021, time=2021-01-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=906958, encodeId=3b50906958a6, content=很需要这方面的知识。, beContent=null, objectType=guider, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=88d75443426, createdName=chen20201211, createdTime=Fri Dec 11 09:20:36 CST 2020, time=2020-12-11, status=1, ipAttribution=)]
    2021-09-16 湘雅科教

    值得学习

    0

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    2021-01-26 ms3000001967035392

    想看

    0

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    2020-12-11 chen20201211

    很需要这方面的知识。

    0