Effects on calcium phosphate homeostasis after sodium-glucose cotransporter 2 inhibitor in patients with advanced chronic kidney disease and type 2 diabetes mellitus

IF 7.4 3区医学 Q1 ENDOCRINOLOGY & METABOLISM Diabetes research and clinical practice Pub Date : 2024-08-14 DOI:10.1016/j.diabres.2024.111818

Gordon Chun Kau Chan , Jack Kit Chung Ng , Cheuk Chun Szeto , Kai Ming Chow

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Abstract

Background

The effects of sodium-glucose cotransporter 2 inhibitors (SGLT2i) on calcium phosphate homeostasis in patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD) remain uncertain.

Methods

A retrospective observational cohort study of patients with T2DM at CKD stage G3b-5ND who received SGLT2i as compared to control from 1 January 2015 through 31 December 2021 was recruited. Propensity score assignment at 1:3 ratio by logistic regression was done. All patients were followed for 12 months. Outcomes were changes in phosphate level.

Results

We analyzed 1,450 SGLT2i users and 4,350 control subjects. At the 12^th month, SGLT2i users had a slower increase in phosphate levels (absolute change: −0.01 ± 0.28 vs + 0.14 ± 0.34 mmol/L; percentage change: −0.74 % ± 25.56 vs + 10.88 ± 28.15 %, P for both < 0.001). The proportion of patients with high phosphate was lower with SGLT2i (8.2 % vs 24.6 % increase). In the generalized estimating equation, SGLT2i was linked to a longitudinal reduction in phosphate (B −0.039, P<0.001).

Conclusions

SGLT2i can effectively slow down the progression of phosphate retention in advanced CKD with T2DM.

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晚期慢性肾病和 2 型糖尿病患者服用钠-葡萄糖共转运体 2 抑制剂后对磷酸钙稳态的影响

背景：钠-葡萄糖共转运体2抑制剂（SGLT2i）对2型糖尿病（T2DM）和慢性肾脏病（CKD）患者体内磷酸钙稳态的影响仍不确定：一项回顾性观察队列研究招募了2015年1月1日至2021年12月31日期间接受SGLT2i治疗的CKD分期为G3b-5ND的T2DM患者与对照组患者。通过逻辑回归按 1:3 的比例进行倾向得分分配。所有患者均接受了 12 个月的随访。结果为磷酸盐水平的变化：我们分析了 1,450 名 SGLT2i 使用者和 4,350 名对照组受试者。第 12 个月时，SGLT2i 使用者的磷酸盐水平上升较慢（绝对变化：-0.01 ± 0.28 vs + 0.14 ± 0.34 mmol/L；百分比变化：-0.74 % ± 25.56 vs + 10.88 ± 28.15 %，P 均为结论：SGLT2i能有效减缓晚期CKD合并T2DM患者磷酸盐潴留的进展。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes research and clinical practice 医学-内分泌学与代谢

CiteScore

10.30

自引率

3.90%

发文量

862

审稿时长

32 days

期刊介绍： Diabetes Research and Clinical Practice is an international journal for health-care providers and clinically oriented researchers that publishes high-quality original research articles and expert reviews in diabetes and related areas. The role of the journal is to provide a venue for dissemination of knowledge and discussion of topics related to diabetes clinical research and patient care. Topics of focus include translational science, genetics, immunology, nutrition, psychosocial research, epidemiology, prevention, socio-economic research, complications, new treatments, technologies and therapy.