제2형 당뇨병 환자에서 장기간의 Sodium-glucose Cotransporter 2 억제제 치료가 신장기능에 미치는 효과

백종하, 오태정, 문주영, 김태희, 고승현, 문민경, 김현정, 이동원, 허규연
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Abstract

Chronic kidney disease is developed commonly in type 2 diabetes mellitus (T2DM) and is the most common cause of end-stage renal disease and related cardiovascular complications. Meanwhile, despite the current standard of care including optimized glucose control and the use of single-agent blockade of the renin-angiotensin-aldosterone system (RAAS), patients with T2DM remain at increased risk for death and complications from cardiorenal causes. The recent studies using sodium-glucose cotransporter 2 (SGLT2) inhibitors have shown not only glucose lowering effect, but also a reduction in blood pressure, weight loss, and a lowering cardiovascular risk. Regarding renal outcomes, the use of SGLT2 inhibitor slows the progression of kidney disease compared to placebo when added to standard care. However, concern has been raised that currently available SGLT2 inhibitors in Korea may be also associated with improved renal outcomes with long-term treatment. As a result, we aimed to evaluate the effect of long-term SGLT2 inhibitor treatment on renal function in the patients with T2DM using meta-analysis. (Korean J Med 2020;95:236-243)
2型糖尿病患者长期使用Sodium-glucose Cotransporter 2抑制剂治疗对肾功能的效果
慢性肾脏疾病常见于2型糖尿病(T2DM),是终末期肾脏疾病和相关心血管并发症的最常见原因。同时,尽管目前的护理标准包括优化血糖控制和使用肾素-血管紧张素-醛固酮系统(RAAS)的单药阻断,T2DM患者死亡和心肾并发症的风险仍然增加。最近的研究表明,钠-葡萄糖共转运蛋白2 (SGLT2)抑制剂不仅具有降血糖作用,而且具有降低血压、减轻体重和降低心血管风险的作用。关于肾脏结局,与安慰剂相比,在标准治疗中使用SGLT2抑制剂可以减缓肾脏疾病的进展。然而,韩国目前可用的SGLT2抑制剂也可能与长期治疗的肾脏预后改善有关,这引起了人们的关注。因此,我们旨在通过荟萃分析评估长期SGLT2抑制剂治疗对T2DM患者肾功能的影响。(韩医2020;95:236-243)
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