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引用次数: 0
摘要
免疫球蛋白 A(IgA)肾病是一种常见的肾小球肾炎,但其治疗方法仍存在争议。推荐使用皮质类固醇已得到支持,但肾素-血管紧张素抑制剂(RAAS)和钠-葡萄糖协同转运体 2 抑制剂(SGLT2i)的使用越来越多,因为与全身性类固醇和免疫抑制治疗相比,它们具有更好的效益/安全性平衡。在本病例报告中,一位患有 2 型糖尿病(T2DM)和活组织检查证实的肾病 IgA 相关性肾病的患者在接受 ACE 抑制剂和 SGLT2i-i 治疗的基础上,又接受了 GLP1-RA 治疗,结果发现蛋白尿迅速明显减少,而且这种效果持续了 2 年。考虑到 GLP1-RA 在糖尿病相关慢性肾病中的有益作用,本病例报告支持这样一种观点,即这些药物也可能是治疗 IgA 肾病的有益选择。
[Anti-Proteinuric Effect of GLP1-RA as Add-On to SGLT2-i and ACE-i in a Diabetic Patient with IgA Nephropathy].
Immunoglobulin A (IgA) nephropathy is a common glomerulonephritis, but its treatment remains matter of debate. Recommendation for corticosteroids has been supported, but renin-angiotensin inhibitors, RAAS, and sodium-glucose co-transporter 2 inhibitors (SGLT2i) are increasingly used because of a better benefit/safety balance in comparison with systemic steroids and immunosuppressive treatments. In this case report, a patient with type 2 diabetes (T2DM) and biopsy-proven nephrotic IgA-related nephropathy documented a rapid meaningful reduction of proteinuria and the effect was persistent for 2 years, after receiving the treatment with a GLP1-RA on top of the previous treatment with ACE-inhibitors and SGLT2-i. Considering the beneficial effects of GLP1-RA in diabetes related chronic kidney disease, the present case report supports the notion that these drugs could also represent a beneficial treatment option in IgA nephropathy.
期刊介绍:
Il Giornale Italiano di Nefrologia (GIN) è la rivista di educazione continua della Società Italiana di Nefrologia SIN ed è pubblicato bimestralmente. E" il più autorevole organo di informazione nefrologia disponibile a livello nazionale. Il giornale Italiano di Nefrologia offre la più aggiornata informazione medico-scientifica rivolta al nefrologo sotto forma di rassegne, casi clinici e articoli finalizzati all’Educazione Continua in Medicina, oltre ai notiziari ed agli atti dei congressi di questa prestigiosa Società Scientifica