钠-葡萄糖共转运蛋白2抑制剂与造影剂诱导肾病风险：一项荟萃分析

IF 2.4 3区医学 Q3 PHARMACOLOGY & PHARMACY

European Journal of Clinical Pharmacology Pub Date : 2025-03-01 Epub Date: 2024-12-27 DOI:10.1007/s00228-024-03799-y

Gang Fan, Lin Lin, Hong Zuo, Rui Yan, Chao Xu

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引用次数: 0

摘要

背景：造影剂肾病（CIN）是在使用造影剂进行诊断或治疗性血管造影干预后发生的一种肾脏不良事件。然而，目前还没有有效和安全的药物治疗CIN，除了水合作用。我们的目的是进行一项meta分析，以验证钠-葡萄糖共转运蛋白2抑制剂（SGLT2is）在预防CIN中的潜在肾保护作用。方法：检索PubMed、Web of Science和中国知网（CNKI）数据库，检索时间自其成立日期至2024年8月26日。使用R中的“Meta”包和Stata软件进行数据分析。结果：共纳入12项研究，包括11项单中心回顾性研究和1项前瞻性队列研究。我们的荟萃分析确定SGLT2is显著降低CIN（优势比（OR） 0.39, 95%可信区间（CI）（0.31, 0.48）， P 2 = 0%）和死亡率（OR 0.45, 95% CI (0.26, 0.77), P = 0.0039, I2 = 48%）。在持续肾替代治疗（CRRT）（OR 0.53, 95% CI (0.15, 1.91), I2 = 0%）或造影剂（MD - 9.68, 95% CI (- 19.38, 0.03), I2 = 71%）方面无显著差异。结论：本研究表明SGLT2is可显著降低糖尿病患者造影剂肾病的发生率。建议未来需要进行大规模随机对照试验（rct）来证实这些发现，并进一步阐明非糖尿病患者的结果。

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Sodium-glucose cotransporter 2 inhibitors and contrast-induced nephropathy risk: a meta-analysis.

Background: Contrast-induced nephropathy (CIN) is an adverse renal event that occurs following the administration of contrast media for diagnostic procedures or therapeutic angiographic intervention. Nevertheless, there is currently no efficacious and safe agents for the treatment of CIN, except for hydration. We aimed to conduct a meta-analysis to verify the potential nephroprotective role of sodium-glucose cotransporter 2 inhibitors (SGLT2is) in the prevention of CIN.

Methods: The PubMed, Web of Science, and China National Knowledge Infrastructure (CNKI) databases were searched from their respective inception dates up until 26 August 2024. The "Meta" package of R and Stata software was used for data analysis.

Results: A total of 12 studies were included in the analysis, comprising 11 single-center retrospective studies and one prospective cohort study. Our meta-analysis determined that SGLT2is significantly decrease CIN (odds ratio (OR) 0.39, 95% confidence interval (CI) (0.31, 0.48), P < 0.0001, I² = 0%) and mortality (OR 0.45, 95% CI (0.26, 0.77), P = 0.0039, I² = 48%). No notable discrepancy was discerned in continuous renal replacement therapy (CRRT) (OR 0.53, 95% CI (0.15, 1.91), I² = 0%) or contrast volume (MD - 9.68, 95% CI (- 19.38, 0.03), I² = 71%).

Conclusion: The present study demonstrated that SGLT2is markedly reduce the incidence of contrast-induced nephropathy in diabetic patients. It is recommended that future large-scale randomized controlled trials (RCTs) are required to confirm these findings and to elucidate further the outcomes in patients without diabetes.

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来源期刊

European Journal of Clinical Pharmacology 医学-药学

CiteScore

5.40

自引率

3.40%

发文量

170

审稿时长

3-8 weeks

期刊介绍： The European Journal of Clinical Pharmacology publishes original papers on all aspects of clinical pharmacology and drug therapy in humans. Manuscripts are welcomed on the following topics: therapeutic trials, pharmacokinetics/pharmacodynamics, pharmacogenetics, drug metabolism, adverse drug reactions, drug interactions, all aspects of drug development, development relating to teaching in clinical pharmacology, pharmacoepidemiology, and matters relating to the rational prescribing and safe use of drugs. Methodological contributions relevant to these topics are also welcomed. Data from animal experiments are accepted only in the context of original data in man reported in the same paper. EJCP will only consider manuscripts describing the frequency of allelic variants in different populations if this information is linked to functional data or new interesting variants. Highly relevant differences in frequency with a major impact in drug therapy for the respective population may be submitted as a letter to the editor. Straightforward phase I pharmacokinetic or pharmacodynamic studies as parts of new drug development will only be considered for publication if the paper involves -a compound that is interesting and new in some basic or fundamental way, or -methods that are original in some basic sense, or -a highly unexpected outcome, or -conclusions that are scientifically novel in some basic or fundamental sense.