• Kazuo Kobayashi, Masao Toyoda, Moritsugu Kimura, Nobuo Hatori, Takayuki Furuki, Hiroyuki Sakai, Masahiro Takihata, Tomoya Umezono, Shun Ito, Daisuke Suzuki, Hiroshi Takeda, Akira Kanamori, Hisakazu Degawa, Hareaki Yamamoto, Hideo Machimura, Atsuko Mokubo, Keiichi Chin, Mitsuo Obana, Toshimasa Hishiki, Kouta Aoyama, Shinichi Nakajima, Shinichi Umezawa, Hidetoshi Shimura, Togo Aoyama, Kazuyoshi Sato, and Masaaki Miyakawa.
• 1 Committee of Hypertension and Kidney Disease, Kanagawa Physicians Association, Yokohama, Japan.
• Diab Vasc Dis Res. 2019 Jan 1; 16 (1): 103-107.

AimThe aim of this study was to assess the renal effects of the glucose-lowering SGLT2 inhibitors in Japanese type 2 diabetes mellitus patients with chronic kidney disease.MethodsThe Kanagawa Physicians Association maintains a registry of patients who visit their 31 clinics. Clinical data of type 2 diabetes mellitus patients with chronic kidney disease, who were prescribed SGLT2 inhibitors in addition to other treatments, were collected and analysed.ResultsSGLT2i was associated with a fall in HbA1c from 64.1 ± 16.7 mmol/mol (8.0 ± 1.5%) to 56.5 ± 12.9 mmol/mol (7.3 ± 1.2%) ( p < 0.01) in 869 analysed cases, a decrease in urine albumin-creatinine ratio from a median of 47.1 to 41.1 mg/gCr, and decrease in estimated glomerular filtration rate from 77.7 ± 23.9 to 75.0 ± 23.9 mL/min/1.73 m2 ( p < 0.01). The effect on albumin-creatinine ratio was independent of age or stage of estimated glomerular filtration; however, there was a significant negative correlation between albumin-creatinine ratio at the initiation of SGLT2 inhibitor and change in ACR. Multiple linear regression analysis identified use of empagliflozin, β-blockers, and sulphonylureas, Δsystolic blood pressure at office, serum Cr and albumin-creatinine ratio value at initiation of SGLT2 inhibitor as independent and significant determinants of change in ACR.ConclusionsThis study confirmed that the beneficial renal effects of SGLT2 inhibitor in Japanese type 2 diabetes mellitus patients with chronic kidney disease, similar to those reported in large-scale clinical trials conducted in Western countries.

48 keywords...

hide…