Sodium-Glucose Cotransporter-2 Inhibitors in Patients with Hereditary Podocytopathies, Alport Syndrome, and FSGS: A Case Series to Better Plan a Large-Scale Study.
Sodium-Glucose Cotransporter-2 Inhibitors in Patients with Hereditary Podocytopathies, Alport Syndrome, and FSGS: A Case Series to Better Plan a Large-Scale Study.
复制标题
DOI：
10.3390/cells10071815
复制
发表时间：
2021-07-18
期刊：
影响因子：
6
通讯作者：
Gross O
中科院分区：
文献类型：
--
作者：
Boeckhaus J;Gross O
肾小球滤过屏障的遗传性疾病的特征在于肾小球基底膜更脆弱和足细胞功能障碍。最近的临床试验已经证明了钠-葡萄糖协同转运蛋白-2抑制剂（SGLT 2 i）在慢性肾病（CKD）中的肾保护作用。假设SGLT 2介导的传入小动脉血管收缩可以纠正遗传性足细胞病中肾小球滤过屏障的血流动力学超载。为了验证这一假设，我们报告了Alport综合征和局灶节段性肾小球硬化症（FSGS）患者的病例系列数据，以了解SGLT 2 i对肾功能的早期影响。平均治疗持续时间为4.5（±2.9）个月。开始SGLT-2 i治疗前和治疗后的平均血清肌酐分别为1.46（±0.42）和1.58（±0.55）mg/dL，开始SGLT-2 i治疗前和治疗后的中位估计肾小球滤过率分别为64（±27）mL/min/1.73 m2和64（±32）mL/min/1.73 m2。开始SGLT-2 i治疗前平均尿白蛋白-肌酐比值（mg/g肌酐）为1827（±1560），开始SGLT-2 i治疗后下降近40%至1127（±854）。据我们所知，这是关于SGLT 2 i在遗传性足细胞病患者中的疗效和安全性的首个病例系列。需要在足细胞病中进行特定的大规模试验，以证实我们在这一人群中的发现，该人群对更有效，早期和安全的肾保护治疗有巨大的未满足的医疗需求。
Hereditary diseases of the glomerular filtration barrier are characterized by a more vulnerable glomerular basement membrane and dysfunctional podocytes. Recent clinical trials have demonstrated the nephroprotective effect of sodium-glucose cotransporter-2 inhibitors (SGLT2i) in chronic kidney disease (CKD). SGLT2-mediated afferent arteriole vasoconstriction is hypothesized to correct the hemodynamic overload of the glomerular filtration barrier in hereditary podocytopathies. To test this hypothesis, we report data in a case series of patients with Alport syndrome and focal segmental glomerulosclerosis (FSGS) with respect of the early effect of SGLT2i on the kidney function. Mean duration of treatment was 4.5 (±2.9) months. Mean serum creatinine before and after SGLT-2i initiation was 1.46 (±0.42) and 1.58 (±0.55) mg/dL, respectively, with a median estimated glomerular filtration rate of 64 (±27) before and 64 (±32) mL/min/1.73 m2 after initiation of SGLT2i. Mean urinary albumin-creatinine ratio in mg/g creatinine before SGLT-2i initiation was 1827 (±1560) and decreased by almost 40% to 1127 (±854) after SGLT2i initiation. To our knowledge, this is the first case series on the effect and safety of SGLT2i in patients with hereditary podocytopathies. Specific large-scale trials in podocytopathies are needed to confirm our findings in this population with a tremendous unmet medical need for more effective, early on, and safe nephroprotective therapies.
登录
查看更多内容
影响因子：
19.6
作者：
Gross, Oliver;Licht, Christoph;Weber, Manfred
通讯作者：
Weber, Manfred
影响因子：
3
作者：
Kashtan, Clifford E.;Gross, Oliver
通讯作者：
Gross, Oliver
影响因子：
19.6
作者：
Gross, Oliver;Toenshoff, Burkhard;Friede, Tim
通讯作者：
Friede, Tim
影响因子：
158.5
作者：
Heerspink, Hiddo J. L.;Stefansson, Bergur V.;Wheeler, David C.
通讯作者：
Wheeler, David C.