Cargando…

Efficacy and Safety of the Use of SGLT2 Inhibitors in Patients on Incremental Hemodialysis: Maximizing Residual Renal Function, Is There a Role for SGLT2 Inhibitors?

SGLT-2i are the new standard of care for diabetic kidney disease (DKD), but previous studies have not included patients on kidney replacement therapy (KRT). Due to their high risk of cardiovascular, renal complications, and mortality, these patients would benefit the most from this therapy. Residual...

Descripción completa

Detalles Bibliográficos
Autores principales: De La Flor, José C., Villa, Daniel, Cruzado, Leónidas, Apaza, Jacqueline, Valga, Francisco, Zamora, Rocío, Marschall, Alexander, Cieza, Michael, Deira, Javier, Rodeles, Miguel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10377393/
https://www.ncbi.nlm.nih.gov/pubmed/37509547
http://dx.doi.org/10.3390/biomedicines11071908
_version_ 1785079506647646208
author De La Flor, José C.
Villa, Daniel
Cruzado, Leónidas
Apaza, Jacqueline
Valga, Francisco
Zamora, Rocío
Marschall, Alexander
Cieza, Michael
Deira, Javier
Rodeles, Miguel
author_facet De La Flor, José C.
Villa, Daniel
Cruzado, Leónidas
Apaza, Jacqueline
Valga, Francisco
Zamora, Rocío
Marschall, Alexander
Cieza, Michael
Deira, Javier
Rodeles, Miguel
author_sort De La Flor, José C.
collection PubMed
description SGLT-2i are the new standard of care for diabetic kidney disease (DKD), but previous studies have not included patients on kidney replacement therapy (KRT). Due to their high risk of cardiovascular, renal complications, and mortality, these patients would benefit the most from this therapy. Residual kidney function (RKF) conveys a survival benefit and cardiovascular health among hemodialysis (HD) patients, especially those on incremental hemodialysis (iHD). We retrospectively describe the safety and efficacy of SGLT2i regarding RKF preservation in seven diabetic patients with different clinical backgrounds who underwent iHD (one or two sessions per week) during a 12-month follow-up. All patients preserved RKF, measured as residual kidney urea clearance (KrU) in 24 h after the introduction of SGLT2i. KrU levels improved significantly from 4.91 ± 1.14 mL/min to 7.28 ± 1.68 mL/min at 12 months (p = 0.028). Pre-hemodialysis blood pressure improved 9.95% in mean systolic blood pressure (SBP) (p = 0.015) and 10.95% in mean diastolic blood pressure (DBP) (p = 0.041); as a result, antihypertensive medication was modified. Improvements in blood uric acid, hemoglobin A1c, urine albumin/creatinine ratio (UACR), and 24 h proteinuria were also significant. Regarding side effects, two patients developed uncomplicated urinary tract infections that were resolved. No other complications were reported. The use of SGLT2i in our sample of DKD patients starting iHD on a 1–2 weekly regimen appears to be safe and effective in preserving RKF.
format Online
Article
Text
id pubmed-10377393
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-103773932023-07-29 Efficacy and Safety of the Use of SGLT2 Inhibitors in Patients on Incremental Hemodialysis: Maximizing Residual Renal Function, Is There a Role for SGLT2 Inhibitors? De La Flor, José C. Villa, Daniel Cruzado, Leónidas Apaza, Jacqueline Valga, Francisco Zamora, Rocío Marschall, Alexander Cieza, Michael Deira, Javier Rodeles, Miguel Biomedicines Case Report SGLT-2i are the new standard of care for diabetic kidney disease (DKD), but previous studies have not included patients on kidney replacement therapy (KRT). Due to their high risk of cardiovascular, renal complications, and mortality, these patients would benefit the most from this therapy. Residual kidney function (RKF) conveys a survival benefit and cardiovascular health among hemodialysis (HD) patients, especially those on incremental hemodialysis (iHD). We retrospectively describe the safety and efficacy of SGLT2i regarding RKF preservation in seven diabetic patients with different clinical backgrounds who underwent iHD (one or two sessions per week) during a 12-month follow-up. All patients preserved RKF, measured as residual kidney urea clearance (KrU) in 24 h after the introduction of SGLT2i. KrU levels improved significantly from 4.91 ± 1.14 mL/min to 7.28 ± 1.68 mL/min at 12 months (p = 0.028). Pre-hemodialysis blood pressure improved 9.95% in mean systolic blood pressure (SBP) (p = 0.015) and 10.95% in mean diastolic blood pressure (DBP) (p = 0.041); as a result, antihypertensive medication was modified. Improvements in blood uric acid, hemoglobin A1c, urine albumin/creatinine ratio (UACR), and 24 h proteinuria were also significant. Regarding side effects, two patients developed uncomplicated urinary tract infections that were resolved. No other complications were reported. The use of SGLT2i in our sample of DKD patients starting iHD on a 1–2 weekly regimen appears to be safe and effective in preserving RKF. MDPI 2023-07-06 /pmc/articles/PMC10377393/ /pubmed/37509547 http://dx.doi.org/10.3390/biomedicines11071908 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
De La Flor, José C.
Villa, Daniel
Cruzado, Leónidas
Apaza, Jacqueline
Valga, Francisco
Zamora, Rocío
Marschall, Alexander
Cieza, Michael
Deira, Javier
Rodeles, Miguel
Efficacy and Safety of the Use of SGLT2 Inhibitors in Patients on Incremental Hemodialysis: Maximizing Residual Renal Function, Is There a Role for SGLT2 Inhibitors?
title Efficacy and Safety of the Use of SGLT2 Inhibitors in Patients on Incremental Hemodialysis: Maximizing Residual Renal Function, Is There a Role for SGLT2 Inhibitors?
title_full Efficacy and Safety of the Use of SGLT2 Inhibitors in Patients on Incremental Hemodialysis: Maximizing Residual Renal Function, Is There a Role for SGLT2 Inhibitors?
title_fullStr Efficacy and Safety of the Use of SGLT2 Inhibitors in Patients on Incremental Hemodialysis: Maximizing Residual Renal Function, Is There a Role for SGLT2 Inhibitors?
title_full_unstemmed Efficacy and Safety of the Use of SGLT2 Inhibitors in Patients on Incremental Hemodialysis: Maximizing Residual Renal Function, Is There a Role for SGLT2 Inhibitors?
title_short Efficacy and Safety of the Use of SGLT2 Inhibitors in Patients on Incremental Hemodialysis: Maximizing Residual Renal Function, Is There a Role for SGLT2 Inhibitors?
title_sort efficacy and safety of the use of sglt2 inhibitors in patients on incremental hemodialysis: maximizing residual renal function, is there a role for sglt2 inhibitors?
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10377393/
https://www.ncbi.nlm.nih.gov/pubmed/37509547
http://dx.doi.org/10.3390/biomedicines11071908
work_keys_str_mv AT delaflorjosec efficacyandsafetyoftheuseofsglt2inhibitorsinpatientsonincrementalhemodialysismaximizingresidualrenalfunctionistherearoleforsglt2inhibitors
AT villadaniel efficacyandsafetyoftheuseofsglt2inhibitorsinpatientsonincrementalhemodialysismaximizingresidualrenalfunctionistherearoleforsglt2inhibitors
AT cruzadoleonidas efficacyandsafetyoftheuseofsglt2inhibitorsinpatientsonincrementalhemodialysismaximizingresidualrenalfunctionistherearoleforsglt2inhibitors
AT apazajacqueline efficacyandsafetyoftheuseofsglt2inhibitorsinpatientsonincrementalhemodialysismaximizingresidualrenalfunctionistherearoleforsglt2inhibitors
AT valgafrancisco efficacyandsafetyoftheuseofsglt2inhibitorsinpatientsonincrementalhemodialysismaximizingresidualrenalfunctionistherearoleforsglt2inhibitors
AT zamorarocio efficacyandsafetyoftheuseofsglt2inhibitorsinpatientsonincrementalhemodialysismaximizingresidualrenalfunctionistherearoleforsglt2inhibitors
AT marschallalexander efficacyandsafetyoftheuseofsglt2inhibitorsinpatientsonincrementalhemodialysismaximizingresidualrenalfunctionistherearoleforsglt2inhibitors
AT ciezamichael efficacyandsafetyoftheuseofsglt2inhibitorsinpatientsonincrementalhemodialysismaximizingresidualrenalfunctionistherearoleforsglt2inhibitors
AT deirajavier efficacyandsafetyoftheuseofsglt2inhibitorsinpatientsonincrementalhemodialysismaximizingresidualrenalfunctionistherearoleforsglt2inhibitors
AT rodelesmiguel efficacyandsafetyoftheuseofsglt2inhibitorsinpatientsonincrementalhemodialysismaximizingresidualrenalfunctionistherearoleforsglt2inhibitors