Real-Time Use of SGLT2i Verified in Pre-dialysis: The RSVP Cross-sectional Study.

IF 2.3 4区 医学 Q3 PHARMACOLOGY & PHARMACY
Annals of Pharmacotherapy Pub Date : 2025-01-01 Epub Date: 2024-05-12 DOI:10.1177/10600280241245995
Aylon Wisbaum, Sandrine Gaudreau, Isabelle Cloutier, Pascale Robert, Regina Kolment, Marie-France Beauchesne, Jodianne Couture
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引用次数: 0

Abstract

Background: The use of sodium-glucose cotransporter 2 inhibitors (SGLT2i) in nephrology practice is increasingly becoming standard of care in patients with diabetes or those with proteinuria.

Objectives: The primary outcome was to identify the proportion of pre-dialysis patients with chronic kidney disease (CKD) G3a, G3b, or G4 prescribed an SGLT2i and describe their characteristics.

Methods: This was a retrospective, multicentric, cross-sectional study of patients with CKD followed at 4 pre-dialysis clinics in the province of Quebec, Canada. We collected data of multiple covariates associated with prescribing SGLT2i in patients over 18 years of age with CKD G3a, G3b, or G4. We then performed a multivariate logistic regression to assess their associations.

Results: Of the 874 patients included, 22.7% were prescribed an SGLT2i. Factors most strongly associated included male sex (odds ratio [OR] = 4.88, 95% CI = 2.38-10.03), being prescribed metformin (OR = 4.30, 95% CI = 2.23-8.31), having type 2 diabetes (OR = 4.00, 95% CI = 1.86-8.62), or having an albumin-to-creatinine ratio greater than 300 mg/g (OR = 1.84, 95% CI = 1.08-3.14). The majority of patients (60.4%) had their SGLT2i initiated by the pre-dialysis clinic and the most frequent adverse event was an initial increase in serum creatinine 1 week after starting treatment (33.9%).

Conclusion and relevance: An increasing number of patients with CKD are being prescribed SGLT2i. Nonetheless, significant disparities in sex, severity of disease, and comorbidities remain. We suggest that specific strategies be put in place to promote prescribing of SGLT2i in women and other at-risk populations, in particular among nephrology teams, to improve patient care.

透析前 SGLT2i 的实时使用验证:RSVP 横截面研究。
背景:钠-葡萄糖共转运体 2 抑制剂(SGLT2i)在肾内科的使用正逐渐成为糖尿病患者或蛋白尿患者的标准治疗方法:主要研究结果是确定慢性肾脏病(CKD)G3a、G3b 或 G4 透析前患者服用 SGLT2i 的比例,并描述其特征:这是一项回顾性、多中心、横断面研究,研究对象是加拿大魁北克省 4 家透析前诊所随访的 CKD 患者。我们收集了与 18 岁以上 CKD G3a、G3b 或 G4 患者开具 SGLT2i 处方相关的多个协变量数据。然后,我们进行了多变量逻辑回归以评估其关联性:在纳入的 874 名患者中,22.7% 的患者处方了 SGLT2i。与之密切相关的因素包括男性(比值比 [OR] = 4.88,95% CI = 2.38-10.03)、二甲双胍处方(OR = 4.30,95% CI = 2.23-8.31)、2 型糖尿病(OR = 4.00,95% CI = 1.86-8.62)或白蛋白与肌酐比值大于 300 mg/g(OR = 1.84,95% CI = 1.08-3.14)。大多数患者(60.4%)在透析前门诊开始使用 SGLT2i,最常见的不良反应是开始治疗 1 周后血清肌酐首次升高(33.9%):越来越多的慢性肾脏病患者正在接受 SGLT2i 治疗。然而,在性别、疾病严重程度和合并症方面仍存在显著差异。我们建议制定具体策略,促进为女性和其他高危人群开具 SGLT2i 处方,尤其是在肾脏内科团队中,以改善患者护理。
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来源期刊
CiteScore
5.70
自引率
0.00%
发文量
166
审稿时长
3-8 weeks
期刊介绍: Annals of Pharmacotherapy (AOP) is a peer-reviewed journal that advances pharmacotherapy throughout the world by publishing high-quality research and review articles to achieve the most desired health outcomes.The articles provide cutting-edge information about the most efficient, safe and cost-effective pharmacotherapy for the treatment and prevention of various illnesses. This journal is a member of the Committee on Publication Ethics (COPE). Average time from submission to first decision: 14 days
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