Postgraduate medicine最新文献

{"title":"Skin ecchymosis in migraine patients: a retrospective and exploratory study.","authors":"Raimundo Pereira Silva-Néto, Adriana de Almeida Soares, Wallyson Pablo de Oliveira Souza, Yasmine Maria Leódido Fortes, Luciano da Silva Lopes, Ana Gabriela Krymchantowski, Carla Jevoux, Abouch Krymchantowski","doi":"10.1080/00325481.2024.2433939","DOIUrl":"10.1080/00325481.2024.2433939","url":null,"abstract":"<p><strong>Background: </strong>Migraine is a recurrent headache disorder characterized by moderate to severe, throbbing pain, typically unilateral. It can be classified as migraine with or without aura, depending on the presence or absence of visual or sensory disturbances known as auras, respectively.</p><p><strong>Aim: </strong>The objective of this study was to determine the prevalence of ecchymosis in patients with migraine and its accuracy parameters in the differential diagnosis between migraine and tension-type headache (TTH).</p><p><strong>Method: </strong>Patients with migraine or tension-type headache, diagnosed according to the International Classification of Headache Disorders (ICHD-3) criteria, were assessed regarding the prevalence of skin ecchymosis, both during headache attacks and in the pain-free period.</p><p><strong>Results: </strong>Four hundred patients were investigated. The subjects were equally divided in two groups presenting the diagnosis of migraine and TTH. Ages were, respectively, 37.3 ± 9.0 years for migraineurs and 40.0 ± 10.0 years for sufferers of TTH. Ecchymosis was present in 76% of patients with migraine and in 11% of patients with TTH (<i>p</i> < 0.0001). In both patients with migraine and TTH, ecchymosis predominated in women, respectively in 92.1% and 63.6% (<i>p</i> < 0.0001). Among the 152 patients with migraine who reported ecchymosis, they were present in most of headache attacks (69.7%), occurred within the first 24 hours after the headache onset (68.4%) and were unilateral in location (65.1%), mainly on the arms (34.9%) and thigh (24.3%). The ecchymosis were larger than 2 cm in diameter (60.5%), lasting longer than four days (89.5%). During the presence of ecchymosis, the headache was unilateral (91.5%), pulsatile (80.3%), severe to very severe (67.8%) and worsening with physical activity (75%).</p><p><strong>Conclusions: </strong>Intermittent skin ecchymosis may be a differentiating factor between migraine and tension-type headache and a specific marker of migraine to be considered as a criterion for its diagnosis.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of influencing factors of exercise systolic blood pressure response in nonalcoholic fatty liver disease aged 40-60 years.","authors":"Xiaoyan Hao, Huihui Zhang, Honghai He, Liyuan Tao, Lei Tian, Wei Zhao, Peng Wang","doi":"10.1080/00325481.2024.2436344","DOIUrl":"10.1080/00325481.2024.2436344","url":null,"abstract":"<p><strong>Objectives: </strong>This study investigated the influencing factors of exercise systolic blood pressure response (ESBPR) by cardiopulmonary exercise test (CPX) in nonalcoholic fatty liver disease (NAFLD) in people aged 40-60 years.</p><p><strong>Methods: </strong>A total of 603 adults were enrolled in this study. The inclusion criteria of this cross-sectional study were adults who underwent health checks and CPX.</p><p><strong>Results: </strong>There were significant differences in body mass Index (BMI) (26.80 ± 2.64 VS 23.31 ± 2.41, <i>p</i> < 0.001) kg/m2, fasting blood glucose (FPG) (5.56 ± 0.94 VS 5.13 ± 0.55, <i>p</i> < 0.001) mmol/L, alanine aminotransferase (ALT), aspartate transaminase (AST), triglycerides (TG), high-density lipoprotein-cholesterol (HDL-C) (1.13 ± 0.22 VS 1.43 ± 0.33, <i>p</i> < 0.001) mmol/L, low-density lipoprotein-cholesterol (LDL-C) (3.21 ± 0.79 VS 2.99 ± 0.68, <i>p</i> = 0.001) mmol/L, resting systolic blood pressure (SBP) (123.53 ± 14.73 VS 118.79 ± 14.79, <i>p</i> < 0.001) mmHg, resting diastolic blood pressure (DBP) (80.29 ± 9.62 VS 75.27 ± 10.41, <i>p</i> < 0.001) mmHg, peak SBP (184.01 ± 23.50 VS 172.81 ± 24.95, <i>p</i> < 0.001) mmHg, peak DBP (87.47 ± 10.50 VS 84.01 ± 11.46, <i>p</i> = 0.001) mmHg, oxygen pulse (VO2/HR) (0.88 ± 0.15 VS 0.92 ± 0.16, <i>p</i> = 0.004) ml/beat, exercise maximum heart rate, carbon dioxide Ventilation equivalent (VE/VCO2) (25.84 ± 4.43 VS 25.12 ± 3.58, <i>p</i> = 0.038), peak oxygen uptake (VO2 peak) (1.78 ± 0.45 VS 1.56 ± 0.46, <i>p</i> < 0.001) mL/min between the NAFLD and control groups. VE/VCO2 (OR = 0.822, <i>p</i> = 0.036) and oxygen uptake/work rate (VO2/WR) (OR = 0.517, <i>p</i> = 0.021) mL/min/watt were associated with a lower risk of ESBPR in NAFLD subjects. Resting SBP was associated with a higher risk of ESBPR in NAFLD patients (OR = 1.059, <i>p</i> = 0.003) and overweight NAFLD subjects (OR = 1.075, <i>p</i> = 0.002). ESBPR (OR = 1.268, <i>p</i> = 0.045), skeletal-muscle mass (OR = 1.305, <i>p</i> < 0.001), and SMI (OR = 1.315, <i>p</i> < 0.001) were linked to an elevated risk of NAFLD in individuals.</p><p><strong>Conclusion: </strong>Our findings indicate that ESBPR is associated with an increased risk of NAFLD in individuals aged 40-60 years. Furthermore, in NAFLD subjects, VE/VCO2 and VO2/WR were found to be correlated with a decreased risk of ESBPR, whereas resting SBP was linked to an elevated risk of ESBPR. This will provide a research basis for the NAFLD subjects who have ESBPR at risk of adverse events during exercise.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Must we remain blind to the need for clinical ethics support services in Africa? Eyes on Nigeria.","authors":"Onochie Okoye, Nkechi Uche, Nkiruka Uzokwe, Rich Umeh","doi":"10.1080/00325481.2024.2433933","DOIUrl":"https://doi.org/10.1080/00325481.2024.2433933","url":null,"abstract":"<p><p>Hospitals and healthcare workers in Africa, and Nigeria specifically, are increasingly being confronted by complex situations, in which decision-making becomes more troublesome in the presence of conflicting goals, values, and preferences among the respective stakeholders. Given that all healthcare decision-making requires ethical considerations, and there is a noted absence or paucity of documentation of institutionalized mechanisms for addressing any associated concern or dilemma in Nigeria, it is thus unclear how most hospitals, healthcare workers, and the public handle the ethical dimensions of patients' care and hospital practice, while also generating possibilities for improvement in care quality. This paper is an attempt to heighten awareness of the need for clinical ethics support services (CESS) in Nigeria and encourage thought, reflection and dialogue over the issues raised. The authors, drawing from their experiences as practicing bioethicists and health care professionals, as well as findings from an unpublished exploratory qualitative study and a review of literature, posit that Nigeria is ripe for the formalization of CESS, especially at the tertiary level of care. Based on the identified bioethics manpower capacity and societal utilization of the existing telecommunication infrastructure in Nigeria, we propose the establishment of a homegrown and socially responsive pilot initiative in which, on-site hospital ethics support services, as well as a web/portal-based or online component will be accessible to all interested healthcare professionals/students, patients, bioethicists, and members of the public. Though the evidence for the effectiveness and impact of CESS and related services on the quality and outcome of care has remained relatively weak and there is no single existing CESS model that has been comprehensively proven to be beneficial to healthcare practice in all settings, we argue that the establishment of formal and homegrown CESS should be of top priority in Nigeria, and Africa generally.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delayed diagnosis of adult onset Still's disease in 2 cases: diagnostic dilemma in positive antinuclear antibody and tuberculosis endemic areas.","authors":"Perdana Aditya Rahman, Pandu Tridana Sakti","doi":"10.1080/00325481.2024.2433930","DOIUrl":"https://doi.org/10.1080/00325481.2024.2433930","url":null,"abstract":"<p><p>Adult-onset Still's disease (AoSD) is a rare systemic autoinflammatory disorder of unknown etiology that affects young adults. Here, we report two cases of delayed AoSD diagnosis, which was initially diagnosed as tuberculous arthritis and systemic lupus erythematosus (SLE) before referral. In the first case, tuberculous arthritis treatment was commenced based on positive interferon-gamma release assay results, whereas in the second case, SLE was diagnosed based on clinical symptoms and positive antinuclear antibody results. There was no clinical improvement after treatment based on the initial diagnosis, patient referral, or diagnostic elaboration. After further evaluation, the clinical and laboratory features were found to be appropriate for the diagnosis of AoSD. Both patients had anemia, fever, arthritis, and high ferritin levels and were treated with high-dose methylprednisolone followed by methotrexate; clinical improvement was observed, and the ferritin levels reduced.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142718117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The triglyceride-glucose index as an indicator of latent atherogenicity of the plasma lipid profile in healthy men with normolipidaemia.","authors":"Anastasiya M Kaneva, Natalya N Potolitsyna, Evgeny R Bojko","doi":"10.1080/00325481.2024.2426970","DOIUrl":"10.1080/00325481.2024.2426970","url":null,"abstract":"<p><strong>Objectives: </strong>The triglyceride-glucose (TyG) index is a novel diagnostic marker for various metabolic and cardiovascular diseases. However, little is known about the association of the TyG index with plasma atherogenicity, especially with its latent forms. The aim of this study was to assess the potential of the use of the TyG index as a marker of atherogenic risk.</p><p><strong>Methods: </strong>A total of 202 men with normolipidaemia, aged 20-60 years, were enrolled in this study. Fasting biochemical parameters were measured. The TyG index was calculated as ln[triglyceride(mg/dL)×glucose(mg/dL)]/2. The diagnostic ability of the TyG index for detecting atherogenic risk was tested by receiver operating characteristic (ROC) curve analysis.</p><p><strong>Results: </strong>A substantial portion of normolipidaemic men had deviations from the reference values for the indices calculated using apolipoproteins. Unfavorable values for the apolipoprotein (apo) B/apoA-I ratio, low-density lipoprotein cholesterol/apoB (LDL-C/apoB) ratio, and the atherogenic index (ATH index) were observed in 32.7%, 31.7%, and 14.4% of men, respectively. The results of ROC curve analysis showed that the TyG index had good diagnostic ability for identifying unfavorable apolipoprotein indices in normolipidaemic men.</p><p><strong>Conclusions: </strong>Thus, the TyG index can be a valuable additional marker for assessing latent atherogenic risk; it can provide useful information for the diagnosis and treatment of early atherosclerosis.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142585114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is it time to finally retire the pantoprazole \"drip\"?","authors":"Ravnit Singh, Nicaulis Gonzalez Lebron, Eduardo A Aviles, Jonathan B Ramharack","doi":"10.1080/00325481.2024.2413356","DOIUrl":"10.1080/00325481.2024.2413356","url":null,"abstract":"","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"789-790"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the potential of artificial intelligence models for triage in the emergency department.","authors":"Fatma Tortum, Kamber Kasali","doi":"10.1080/00325481.2024.2418806","DOIUrl":"10.1080/00325481.2024.2418806","url":null,"abstract":"<p><strong>Objective: </strong>To perform a comparative analysis of the three-level triage protocol conducted by triage nurses and emergency medicine doctors with the use of ChatGPT, Gemini, and Pi, which are recognized artificial intelligence (AI) models widely used in the daily life.</p><p><strong>Materials and methods: </strong>The study was prospectively conducted with patients presenting to the emergency department of a tertiary care hospital from 1 April 2024, to 7 April 2024. Among the patients who presented to the emergency department over this period, data pertaining to their primary complaints, arterial blood pressure values, heart rates, peripheral oxygen saturation values measured by pulse oximetry, body temperature values, age, and gender characteristics were analyzed. The triage categories determined by triage nurses, the abovementioned AI chatbots, and emergency medicine doctors were compared.</p><p><strong>Results: </strong>The study included 500 patients, of whom 23.8% were categorized identically by all triage evaluators. Compared to the triage conducted by emergency medicine doctors, triage nurses overtriaged 6.4% of the patients and undertriaged 3.1% of the yellow-coded patients and 3.4% of the red-coded patients. Of the AI chatbots, ChatGPT exhibited the closest triage approximation to that of emergency medicine doctors; however, its undertriage rates were 26.5% for yellow-coded patients and 42.6% for red-coded patients.</p><p><strong>Conclusion: </strong>The undertriage rates observed in AI models were considerably high. Hence, it does not yet seem appropriate to solely rely on the specified AI models for triage purposes in the emergency department.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"841-846"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SGLT2 inhibitors across the spectrum of chronic kidney disease: a narrative review.","authors":"Lance Sloan","doi":"10.1080/00325481.2024.2418795","DOIUrl":"10.1080/00325481.2024.2418795","url":null,"abstract":"<p><p>Chronic kidney disease (CKD) is a growing public health concern, affecting at least 1 in 7 adults in the United States, and accounting for a large proportion of healthcare spending. The risk of mortality rises steeply with declining kidney function, mostly due to cardiovascular-related deaths. Since CKD is asymptomatic in the early stages, diagnosis is sometimes delayed. However, early diagnosis is important for timely initiation of interventions to reduce disease progression, and to avoid the need for hospitalizations, dialysis, or kidney transplantation. This review focuses on the impact of sodium glucose transporter 2 inhibitors (SGLT2i) on CKD based on mechanistic and clinical trial evidence. These agents affect the kidneys through changes in sodium transport and metabolic factors that interfere with the primary pathological mechanisms shared by most kidney diseases. Following clinical trials of SGLT2i in patients with type 2 diabetes which demonstrated reductions in the risk of major adverse CV events, death, and hospitalizations for heart failure (HHF), and in patients with heart failure (HF) with and without diabetes which showed reductions in death and HHF, recent trials in patients with CKD have provided overwhelming support for the use of SGLT2i as foundational therapy across a broad spectrum of patients with CKD, regardless of diabetes status, primary kidney disease (except polycystic kidney disease), or kidney function. While clinical trials in CKD generally recruit patients with a high risk of events, patients at lower risk could also benefit from SGLT2i in terms of reduction of CKD progression, HF, and death, as well as other beneficial effects including reductions in blood sugar, body weight, and blood pressure.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"801-809"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pentoxifylline improves anemia through its novel effect on hypoxia-inducible factor-2 alpha in hemodialysis patients: a randomized, double-blind, placebo-controlled clinical trial.","authors":"Hadeer Zakaria, Noha Alaa Hamdy, Nagy Ah Sayed-Ahmed, Ahmed El-Mallah","doi":"10.1080/00325481.2024.2426448","DOIUrl":"10.1080/00325481.2024.2426448","url":null,"abstract":"<p><strong>Objectives: </strong>This randomized, double-blind, placebo-controlled clinical trial aimed to prospectively examine the effect of pentoxifylline (PTX) on hypoxia-inducible factor-2 alpha (HIF-2α) and its role in controlling anemia in hemodialysis (HD) patients.</p><p><strong>Methods: </strong>Eighty patients on HD were randomized to receive 400 mg of PTX or placebo twice daily for 6 months. The hemoglobin (Hb) and other hematologic parameters, the weekly erythropoiesis-stimulating agents (ESAs), and the ESA resistance index (ERI) were assessed monthly during the study. The HIF-2α, transforming growth factor-β1 (TGF-β1), and high-sensitivity C-reactive protein (hs.CRP) were measured before and after the intervention.</p><p><strong>Results: </strong>In the pentoxifylline group, an appreciable increase in Hb from 9.7 (9.3, 10.3) g/dl to 10.5 (9.3, 11.4) g/dl and hematocrit (Hct) from 31.3 (29.6, 32.4)% to 33.2 (29.4, 35.9)% was observed after one month of PTX administration, and this effect was maintained over the study time (<i>p</i> < 0.001). This was along with a decrease in the ESA doses required from 8000 (8000, 11500) IU/wk to 4000 (2000, 8000) IU/wk (<i>p</i> < 0.001), and an improvement in the ERI from 11.6 (8.07, 16.97) IU/kg/wk/g/dl to 5.79 (2.01, 10.09) IU/kg/wk/g/dl (<i>p</i> < 0.001). Additionally, the HIF-2α increased significantly at the end of the intervention in patients who received PTX from 3245.35 (2886.8, 4691.56) pg/ml to 7208.75 (5382, 9182.7) pg/ml, while TGF-β1 and hs.CRP decreased significantly from 657.78 (539.78, 1146.62) pg/ml and 88.08 (39.93, 100.4) mg/l to 329.94 (228.67, 793.18) pg/ml and 48.65 (34.44, 84.61) mg/l, respectively. The percent changes in HIF-2α, TGF-β1, and hs.CRP levels in the pentoxifylline group were also statistically significant in comparison with the placebo group.</p><p><strong>Conclusions: </strong>PTX could be a promising agent for correcting anemia in HD patients via increasing HIF-2α levels.</p><p><strong>Clinical trial registration: </strong>Clinicaltrials.gov, February 2023, registry number: NCT05708248.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"847-854"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142585001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nephroprotective effect of SGLT2 inhibitors in elderly patients with type 2 diabetes mellitus and hypertension: a real-world population-based cohort study.","authors":"Shasha Geng, Yang Li, Jianli Ge, Yue Liu, Qingqing Li, Xin Chen, Yingqian Zhu, Xiaotong Guo, Huixiao Yuan, Xiaoli Wang, Hua Jiang","doi":"10.1080/00325481.2024.2426442","DOIUrl":"10.1080/00325481.2024.2426442","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate the nephroprotective effect of sodium-glucose cotransporter 2 inhibitors (SGLT2i) in elderly patients with type 2 diabetes mellitus (T2DM) and hypertension based on real-world clinical data. The study aimed to provide a theoretical basis for evidence-based pharmacological treatment of chronic kidney disease in this population.</p><p><strong>Methods: </strong>The 'Health Cloud' platform of the Shanghai Municipal Health Commission was employed to identify and screen elderly patients with T2DM and hypertension. The propensity score matching cohort was further constructed to estimate the effect of SGLT2i on the risk of rapid decline in renal function (∆eGFR≤-5 mL/min/1.73 m² or ∆eGFR%≤-5%). Multiple sensitivity analyses were conducted to assess the robustness of the results.</p><p><strong>Results: </strong>After propensity score matching, no significant differences of covariates were identified between the SGLT2i and non-SGLT2i groups. The results of multivariate logistic models demonstrated a consistent and inverse correlation between SGLT2i use and the risk of rapid eGFR decline, whether defined as ∆eGFR≤-5 mL/min/1.73 m² (OR = 0.60, 95% CI:0.38-0.96) or ∆eGFR%≤-5% (OR = 0.57, 95% CI:0.37-0.89). In the stratification of renin-angiotensin system inhibitor (RASi) treatment, SGLT2i was associated with a lower risk of rapid eGFR decline in the RASi group (all ORs < 1, <i>p</i> < 0.05), with no interaction between SGLT2i and RASi (all P for interaction > 0.05) detected.</p><p><strong>Conclusions: </strong>SGLT2i significantly reduced the risk of rapid eGFR decline in elderly patients with T2DM and hypertension, but the synergistic effect with RASi remains unclear.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"855-863"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}