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Renal effects of a sodium‐glucose cotransporter 2 inhibitor, tofogliflozin, in relation to sodium intake and glycaemic status

AIMS: Little is known about whether sodium intake is associated with the clinical effects of SGLT2 inhibitors (SGLT2is); however, SGLT2is may increase urinary sodium excretion. Thus, we investigated the impact of daily sodium intake on the estimated glomerular filtration rate (eGFR) via an SGLT2i, t...

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Autores principales: Nunoi, Kiyohide, Sato, Yuichi, Kaku, Kohei, Yoshida, Akihiro, Suganami, Hideki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Blackwell Publishing Ltd 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6619387/
https://www.ncbi.nlm.nih.gov/pubmed/30945431
http://dx.doi.org/10.1111/dom.13731
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author Nunoi, Kiyohide
Sato, Yuichi
Kaku, Kohei
Yoshida, Akihiro
Suganami, Hideki
author_facet Nunoi, Kiyohide
Sato, Yuichi
Kaku, Kohei
Yoshida, Akihiro
Suganami, Hideki
author_sort Nunoi, Kiyohide
collection PubMed
description AIMS: Little is known about whether sodium intake is associated with the clinical effects of SGLT2 inhibitors (SGLT2is); however, SGLT2is may increase urinary sodium excretion. Thus, we investigated the impact of daily sodium intake on the estimated glomerular filtration rate (eGFR) via an SGLT2i, tofogliflozin (TOFO), in patients with type 2 diabetes (T2D). METHODS: Individual‐level data on 775 T2D patients in TOFO Phase 3 trials were analysed. Adjusted changes in variables during 52 weeks of TOFO therapy were compared according to basal daily salt intake (DSI), which was measured based on estimated daily urinary sodium excretion using the Tanaka formula. Multivariable analysis was used to investigate the impact of basal DSI on changes in eGFR at Weeks 4 and 52. RESULTS: Sixty‐six percent of participants were men; mean age, HbA1c, body mass index, eGFR(MDRD) and median DSI were 58.5 years, 8.0%, 25.6 kg/m(2), 83.9 mL/min/1.73 m(2) and 9.3 g/d, respectively. In all participants, eGFR(MDRD) sharply dipped during Week 4, and gradually increased by Week 52, showing a significant increase overall from baseline to Week 52. Multivariable analysis showed that basal DSI and HbA1c levels were independently correlated with eGFR(MDRD) changes at Weeks 4 and 52. Additionally, lower baseline HbA1c and DSI levels were significantly correlated with a greater increase in eGFR(MDRD) at Week 52. CONCLUSIONS: Dietary salt intake, in addition to glycaemic control, correlates with changed eGFR(MDRD) via TOFO. Thus, an appropriate dietary approach to therapy should be considered before treatment of T2D patients with an SGLT2i.
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spelling pubmed-66193872019-07-22 Renal effects of a sodium‐glucose cotransporter 2 inhibitor, tofogliflozin, in relation to sodium intake and glycaemic status Nunoi, Kiyohide Sato, Yuichi Kaku, Kohei Yoshida, Akihiro Suganami, Hideki Diabetes Obes Metab Original Articles AIMS: Little is known about whether sodium intake is associated with the clinical effects of SGLT2 inhibitors (SGLT2is); however, SGLT2is may increase urinary sodium excretion. Thus, we investigated the impact of daily sodium intake on the estimated glomerular filtration rate (eGFR) via an SGLT2i, tofogliflozin (TOFO), in patients with type 2 diabetes (T2D). METHODS: Individual‐level data on 775 T2D patients in TOFO Phase 3 trials were analysed. Adjusted changes in variables during 52 weeks of TOFO therapy were compared according to basal daily salt intake (DSI), which was measured based on estimated daily urinary sodium excretion using the Tanaka formula. Multivariable analysis was used to investigate the impact of basal DSI on changes in eGFR at Weeks 4 and 52. RESULTS: Sixty‐six percent of participants were men; mean age, HbA1c, body mass index, eGFR(MDRD) and median DSI were 58.5 years, 8.0%, 25.6 kg/m(2), 83.9 mL/min/1.73 m(2) and 9.3 g/d, respectively. In all participants, eGFR(MDRD) sharply dipped during Week 4, and gradually increased by Week 52, showing a significant increase overall from baseline to Week 52. Multivariable analysis showed that basal DSI and HbA1c levels were independently correlated with eGFR(MDRD) changes at Weeks 4 and 52. Additionally, lower baseline HbA1c and DSI levels were significantly correlated with a greater increase in eGFR(MDRD) at Week 52. CONCLUSIONS: Dietary salt intake, in addition to glycaemic control, correlates with changed eGFR(MDRD) via TOFO. Thus, an appropriate dietary approach to therapy should be considered before treatment of T2D patients with an SGLT2i. Blackwell Publishing Ltd 2019-05-06 2019-07 /pmc/articles/PMC6619387/ /pubmed/30945431 http://dx.doi.org/10.1111/dom.13731 Text en © 2019 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Nunoi, Kiyohide
Sato, Yuichi
Kaku, Kohei
Yoshida, Akihiro
Suganami, Hideki
Renal effects of a sodium‐glucose cotransporter 2 inhibitor, tofogliflozin, in relation to sodium intake and glycaemic status
title Renal effects of a sodium‐glucose cotransporter 2 inhibitor, tofogliflozin, in relation to sodium intake and glycaemic status
title_full Renal effects of a sodium‐glucose cotransporter 2 inhibitor, tofogliflozin, in relation to sodium intake and glycaemic status
title_fullStr Renal effects of a sodium‐glucose cotransporter 2 inhibitor, tofogliflozin, in relation to sodium intake and glycaemic status
title_full_unstemmed Renal effects of a sodium‐glucose cotransporter 2 inhibitor, tofogliflozin, in relation to sodium intake and glycaemic status
title_short Renal effects of a sodium‐glucose cotransporter 2 inhibitor, tofogliflozin, in relation to sodium intake and glycaemic status
title_sort renal effects of a sodium‐glucose cotransporter 2 inhibitor, tofogliflozin, in relation to sodium intake and glycaemic status
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6619387/
https://www.ncbi.nlm.nih.gov/pubmed/30945431
http://dx.doi.org/10.1111/dom.13731
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