Role of SGLT-2 Inhibitors in Ultrafiltration Failure in Peritoneal Dialysis: A Narrative Review.

IF 1.6 Q3 UROLOGY & NEPHROLOGY
Canadian Journal of Kidney Health and Disease Pub Date : 2024-11-05 eCollection Date: 2024-01-01 DOI:10.1177/20543581241293500
Magdalena Riedl Khursigara, Ping Liu, Reetinder Kaur, Thomas A Mavrakanas
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Abstract

Purpose of review: Sodium-glucose co-transporter-2 (SGLT-2) inhibitors are glucose lowering agents with protective effects on cardiovascular health and the ability to slow chronic kidney disease (CKD) progression. The benefits of SGLT-2 inhibitors have not been studied in patients with advanced CKD or on maintenance dialysis. Ultrafiltration failure is a common reason for failure of peritoneal dialysis (PD). Glucose transporters, such as SGLT-2, are involved in the progression to ultrafiltration failure, and hence, SGLT-2 inhibitors might be beneficial in patients on PD to prevent ultrafiltration failure.

Source of information: Here, we review data from animal models and ongoing clinical trials of SGLT-2 inhibitors in advanced CKD, as well as considerations for a phase III trial in patients on PD.

Methods: A literature search was conducted and information on clinical trials was obtained from clinicaltrials.gov.

Key findings: Animal models of PD have shown upregulation of glucose transporters in the peritoneal membrane and a potential effect of SGLT-2 inhibitors on glucose absorption and ultrafiltration. Several clinical trials are currently ongoing with SGLT-2 inhibitors in patients on PD. We discuss their study designs and propose a mixed-methods, patient-centered approach to studying SGLT-2 inhibitors in PD patients. We also discuss the potential implications of SGLT-2 inhibitors on people living with kidney failure, especially in remote communities.

SGLT-2 抑制剂在腹膜透析超滤失败中的作用:叙述性综述。
综述目的:钠-葡萄糖共转运体-2(SGLT-2)抑制剂是一种降糖药物,对心血管健康具有保护作用,并能延缓慢性肾病(CKD)的进展。目前尚未研究 SGLT-2 抑制剂对晚期 CKD 患者或维持性透析患者的益处。超滤失败是腹膜透析(PD)失败的常见原因。SGLT-2等葡萄糖转运体参与了超滤衰竭的进展,因此,SGLT-2抑制剂可能有利于腹膜透析患者预防超滤衰竭:在此,我们回顾了SGLT-2抑制剂在晚期CKD中的动物模型和正在进行的临床试验数据,以及在PD患者中进行III期试验的考虑因素:方法:进行文献检索,并从 clinicaltrials.gov.cn 获取临床试验信息:主要发现:腹膜透析动物模型显示腹膜葡萄糖转运体上调,SGLT-2抑制剂对葡萄糖吸收和超滤有潜在影响。目前正在进行几项针对腹膜透析患者的 SGLT-2 抑制剂临床试验。我们讨论了它们的研究设计,并提出了一种以患者为中心的混合方法来研究 SGLT-2 抑制剂在帕金森病患者中的应用。我们还讨论了 SGLT-2 抑制剂对肾衰竭患者,尤其是偏远社区患者的潜在影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.00
自引率
5.90%
发文量
84
审稿时长
12 weeks
期刊介绍: Canadian Journal of Kidney Health and Disease, the official journal of the Canadian Society of Nephrology, is an open access, peer-reviewed online journal that encourages high quality submissions focused on clinical, translational and health services delivery research in the field of chronic kidney disease, dialysis, kidney transplantation and organ donation. Our mandate is to promote and advocate for kidney health as it impacts national and international communities. Basic science, translational studies and clinical studies will be peer reviewed and processed by an Editorial Board comprised of geographically diverse Canadian and international nephrologists, internists and allied health professionals; this Editorial Board is mandated to ensure highest quality publications.
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