Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy
Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy
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DOI：
10.1056/nejmoa1811744
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发表时间：
2019-06-13
影响因子：
158.5
通讯作者：
Bentley-Lewis, Rhonda
中科院分区：
文献类型：
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作者：
Perkovic, V.;Jardine, M. J.;Bentley-Lewis, Rhonda
背景2型糖尿病是全世界肾衰竭的主要原因，但很少有有效的长期治疗方法。在钠-葡萄糖协同转运蛋白2（SGLT 2）抑制剂的心血管试验中，探索性结果表明，此类药物可能改善2型糖尿病患者的肾脏结局。方法在这项双盲、随机试验中，我们将2型糖尿病和蛋白尿性慢性肾脏病患者分配接受卡格列净（一种口服SGLT 2抑制剂，每日100 mg）或安慰剂治疗。所有患者的估计肾小球滤过率（GFR）为30至300至5000），并接受了肾素-血管紧张素系统阻断治疗。主要结局是终末期肾病（透析、移植或持续估计GFR <1.5）的复合终点。
Background Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium-glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. Methods In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to 300 to 5000) and were treated with renin-angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of