Correlation between albuminuria and interstitial injury marker reductions associated with SGLT2 inhibitor treatment in diabetic patients with renal dysfunction
Abstract Background We investigated the effects of sodium–glucose cotransporter 2 inhibitor (SGLT2i) administration focusing on its involvement in tubulo-interstitial disorders in diabetic kidney. Methods Enrolled patients with diabetic kidney disease received a mean dose of 52.3 mg of an SGLT2i (ip...
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| Format: | Article |
| Language: | English |
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BMC
2022-08-01
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| Series: | European Journal of Medical Research |
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| Online Access: | https://doi.org/10.1186/s40001-022-00737-5 |
| _version_ | 1811342720085524480 |
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| author | Saeko Sato Kaori Takayanagi Taisuke Shimizu Koichi Kanozawa Takatsugu Iwashita Hajime Hasegawa |
| author_facet | Saeko Sato Kaori Takayanagi Taisuke Shimizu Koichi Kanozawa Takatsugu Iwashita Hajime Hasegawa |
| author_sort | Saeko Sato |
| collection | DOAJ |
| description | Abstract Background We investigated the effects of sodium–glucose cotransporter 2 inhibitor (SGLT2i) administration focusing on its involvement in tubulo-interstitial disorders in diabetic kidney. Methods Enrolled patients with diabetic kidney disease received a mean dose of 52.3 mg of an SGLT2i (ipragliflozin) daily. Blood and urine were sampled at 0, 1, and 12 months (M). Results Non-renal-dysfunction patients (NRD: baseline eGFR ≥ 60 mL/min/1.73 m2, n = 12) and renal-dysfunction patients (RD: baseline eGFR < 60 mL/min/1.73 m2, n = 9) were analyzed separately. The median urine albumin-to-Cr ratio (ACR) was significantly decreased at 1 M in both groups (NRD: 163.1 at 0 M vs 118.5 mg/g Cr at 1 M, RD: 325.2 at 0 M vs 136.0 mg/g Cr at 1 M). In the RD, but not the NRD group, reduction of urine monocyte chemotactic protein-1 (MCP-1) by SGLT2i showed a significant difference between high-responders (HR: − 25.7 ± 11.4%) and low-responders (LR: 59.2 ± 17.0%), defined by ACR reduction at 1 M. Univariate analysis showed a significant correlation between the reduction of ACR and MCP-1 (R = 0.683, p = 0.042) in RD. Conclusion SGLT2i exerted an anti-albuminuric effect regardless of the presence/absence of renal dysfunction. However, the anti-albuminuric effect of SGLT2i in patients with renal dysfunction appears more closely associated with amelioration of tubulo-interstitial disorders compared to patients without renal dysfunction. |
| first_indexed | 2024-04-13T19:15:43Z |
| format | Article |
| id | doaj.art-996f082aa62c47008eda3563137b0dd3 |
| institution | Directory Open Access Journal |
| issn | 2047-783X |
| language | English |
| last_indexed | 2024-04-13T19:15:43Z |
| publishDate | 2022-08-01 |
| publisher | BMC |
| record_format | Article |
| series | European Journal of Medical Research |
| spelling | doaj.art-996f082aa62c47008eda3563137b0dd32022-12-22T02:33:41ZengBMCEuropean Journal of Medical Research2047-783X2022-08-012711910.1186/s40001-022-00737-5Correlation between albuminuria and interstitial injury marker reductions associated with SGLT2 inhibitor treatment in diabetic patients with renal dysfunctionSaeko Sato0Kaori Takayanagi1Taisuke Shimizu2Koichi Kanozawa3Takatsugu Iwashita4Hajime Hasegawa5Department of Nephrology and Hypertension, Saitama Medical Center, Saitama Medical UniversityDepartment of Nephrology and Hypertension, Saitama Medical Center, Saitama Medical UniversityDepartment of Nephrology and Hypertension, Saitama Medical Center, Saitama Medical UniversityDepartment of Nephrology and Hypertension, Saitama Medical Center, Saitama Medical UniversityDepartment of Nephrology and Hypertension, Saitama Medical Center, Saitama Medical UniversityDepartment of Nephrology and Hypertension, Saitama Medical Center, Saitama Medical UniversityAbstract Background We investigated the effects of sodium–glucose cotransporter 2 inhibitor (SGLT2i) administration focusing on its involvement in tubulo-interstitial disorders in diabetic kidney. Methods Enrolled patients with diabetic kidney disease received a mean dose of 52.3 mg of an SGLT2i (ipragliflozin) daily. Blood and urine were sampled at 0, 1, and 12 months (M). Results Non-renal-dysfunction patients (NRD: baseline eGFR ≥ 60 mL/min/1.73 m2, n = 12) and renal-dysfunction patients (RD: baseline eGFR < 60 mL/min/1.73 m2, n = 9) were analyzed separately. The median urine albumin-to-Cr ratio (ACR) was significantly decreased at 1 M in both groups (NRD: 163.1 at 0 M vs 118.5 mg/g Cr at 1 M, RD: 325.2 at 0 M vs 136.0 mg/g Cr at 1 M). In the RD, but not the NRD group, reduction of urine monocyte chemotactic protein-1 (MCP-1) by SGLT2i showed a significant difference between high-responders (HR: − 25.7 ± 11.4%) and low-responders (LR: 59.2 ± 17.0%), defined by ACR reduction at 1 M. Univariate analysis showed a significant correlation between the reduction of ACR and MCP-1 (R = 0.683, p = 0.042) in RD. Conclusion SGLT2i exerted an anti-albuminuric effect regardless of the presence/absence of renal dysfunction. However, the anti-albuminuric effect of SGLT2i in patients with renal dysfunction appears more closely associated with amelioration of tubulo-interstitial disorders compared to patients without renal dysfunction.https://doi.org/10.1186/s40001-022-00737-5Diabetic tubulopathyFibrosisMCP-1ProteinuriaType 2 diabetesN-Acetyl-β-D-glucosaminidase |
| spellingShingle | Saeko Sato Kaori Takayanagi Taisuke Shimizu Koichi Kanozawa Takatsugu Iwashita Hajime Hasegawa Correlation between albuminuria and interstitial injury marker reductions associated with SGLT2 inhibitor treatment in diabetic patients with renal dysfunction European Journal of Medical Research Diabetic tubulopathy Fibrosis MCP-1 Proteinuria Type 2 diabetes N-Acetyl-β-D-glucosaminidase |
| title | Correlation between albuminuria and interstitial injury marker reductions associated with SGLT2 inhibitor treatment in diabetic patients with renal dysfunction |
| title_full | Correlation between albuminuria and interstitial injury marker reductions associated with SGLT2 inhibitor treatment in diabetic patients with renal dysfunction |
| title_fullStr | Correlation between albuminuria and interstitial injury marker reductions associated with SGLT2 inhibitor treatment in diabetic patients with renal dysfunction |
| title_full_unstemmed | Correlation between albuminuria and interstitial injury marker reductions associated with SGLT2 inhibitor treatment in diabetic patients with renal dysfunction |
| title_short | Correlation between albuminuria and interstitial injury marker reductions associated with SGLT2 inhibitor treatment in diabetic patients with renal dysfunction |
| title_sort | correlation between albuminuria and interstitial injury marker reductions associated with sglt2 inhibitor treatment in diabetic patients with renal dysfunction |
| topic | Diabetic tubulopathy Fibrosis MCP-1 Proteinuria Type 2 diabetes N-Acetyl-β-D-glucosaminidase |
| url | https://doi.org/10.1186/s40001-022-00737-5 |
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