Effects of Sodium–Glucose Cotransporter 2 Inhibitors in Diabetic and Non-Diabetic Patients with Advanced Chronic Kidney Disease in Peritoneal Dialysis on Residual Kidney Function: In Real-World Data
Abstract
:1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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All (N = 16) | NoDM | DM | p-Value | |
---|---|---|---|---|
(N = 8) | (N = 8) | |||
Age—years, mean (SD) | 67.3 (10.3) | 64.5 (9.9) | 70 (10.6) | 0.2 |
Sex—female, n (%) | 6 (37.5) | 4 (50) | 2 (25) | 0.3 |
Dry weight (Kg), mean (SD) | 75.7 (18.3) | 70.4 (21.3) | 81.1 (14.1) | 0.3 |
BMI (kg/m2), mean (SD) | 28.4 (6.1) | 25.73 (6.31) | 31.1 (4.9) | 0.07 |
Causes of CKD, n (%) | 0.1 | |||
Unknown origin | 7 (43.8) | 2 (25) | 5 (62.5) | |
Glomerular disease | 5 (31.3) | 2 (25) | 3 (37.5) | |
CTIN | 1 (6.3) | 1 (12.5) | 0 | |
ADPKD | 3 (18.8) | 3 (37.5) | 0 | |
HbA1c level, n (%) | 6.0 (0.9) | 5.4 (0.6) | 6.6 (0.8) | <0.001 |
Hypertension, n (%) | 16 (100) | 16 (100) | 16 (100) | |
ACE inhibitors/ARB | 16 (100) | 8 (100) | 8 (100) | |
ACC | 6 (37.5) | 3 (37.5) | 3 (37.5) | |
Loop diuretics | 13 (81.3) | 6 (75) | 7 (87.5) | |
MRA | 9 (56.3) | 1 (12.5) | 8 (100) | |
Thiazides | 6 (37.5) | 4 (50) | 2 (25) | |
Alpha blockers | 5 (31.3) | 2 (25) | 3 (37.5) | |
Beta blockers | 7 (43.8) | 4 (50) | 3 (37.55) | |
SGLT-2 inhibitors, n (%) | 0.5 | |||
Empagliflozin | 13 (81.2) | 7 (87.5) | 6 (75) | |
Dapagliflozin | 3 (18.8) | 1 (12.5) | 2 (25) | |
PD vintage (months), mean (SD) | 21.1 (15.0) | 13.1 (8.1) | 29.1 (16.5) | 0.03 |
Technical peritoneal dialysis, n (%) | ||||
APD | 4 (25) | 3 (37.5) | 1 (12.5) | 0.2 |
CAPD | 12 (75) | 5 (62.5) | 7 (87.5) | |
Technical prescription, n (%) | ||||
Icodextrin | 10 (62.5) | 5 (62.5) | 5 (62.5) | 1 |
Peritoneal equilibrium test: | ||||
D/P, mean (SD) | 0.76 (0.12) | 0.78 (0.11) | 0.74 (0.13) | 0.9 |
D/D0, mean (SD) | 0.29 (0.1) | 0.29 (0.09) | 0.29 (0.09) | |
Peritoneal membrane function classification: | 0.4 | |||
Low transporter, number (%) | 1 (6.3) | 0 | 1 (12.5) | |
Average transporter, number (%) | 11 (68.8) | 5 (62.5) | 6 (75) | |
High transporter, number (%) | 4 (25.0) | 3 (37.5) | 1 (12.5) | |
Ultrafiltration volume (mL/day), median [IQR] | 425 [250–600] | 525 [300–650] | 375 [250–550] | 0.3 |
nPCR, mean (SD) | 0.94 (0.16) | 0.94 (0.16) | 0.94 (0.18) | 0.9 |
Residual diuresis (L), mean (SD) | 1.5 (0.7) | 1.35 Lt (0.315) | 1.69 (0.9) | 0.3 |
KrU (SD), mL/min, mean (SD) | 4.1 (2.5) | 3.67 (2.36) | 4.6 (2.8) | 0.5 |
ClCr (SD), mL/min, mean (SD) | 7.45 (4.2) | 10.05 (6.6) | ||
Kt/V week, mean (SD) | 2.1 (0.4) | 2.1 (0.2) | 2.1(0.6) | 0.9 |
24 h proteinuria (g/day), median [IQR] | 489.7 [192.6–1128] | 229 [172.8–955.3] | 622.9 [398.8–2130] | 0.3 |
MAU 24 h urine (mg/day), median [IQR] | 283 [65.2–553] | 105.6 [47.6–450.0] | 408 [188.7–1414.8] | 0.2 |
SBP (mmHg), mean (SD) | 139.8 (10.2) | 141 (9.9) | 138.6 (11.0) | 0.7 |
DBP (mmHg), mean (SD) | 71.4 (8.1) | 73.6 (7.4) | 69.3 (8.6) | 0.3 |
Bicarbonate, mean (SD) | 22.1 (2.1) | 22.0 (1.5) | 22.1 (2.7) | 0.9 |
Baseline | 3 Months | 6 Months | p-Value ANOVA | |
---|---|---|---|---|
N | 16 | 13 | 12 | |
Weight (kg), mean (SD) | 75.7 (18.3) | 73.6 (16.9) | 72.8 (16.7) | 0.2 |
Hb (g/dL), mean (SD) | 12.2 (1.5) | 11.6 (1.6) | 11.8 (0.8) | 0.5 |
Cr (g/dL), mean (SD) | 6.6 (2.3) | 7.2 (2) | 7.1 (1.9) | 0.9 |
CKD-EPI 2021 (mL/min/1.73m2), mean (SD) | 8.3 (3.6) | 7.2 (2.9) | 7.5 (3.6) | 0.8 |
Urea (mmol/mL), mean (SD) | 139.4 (32.9) | 135.8 (28) | 131.8 (21.2) | 0.2 |
Sodium (mmol/L), mean (SD) | 137.1 (3) | 136.4 (3.2) | 137.1 (1.9) | 0.7 |
Potassium (mmol/L), mean (SD) | 4.8 (0.7) | 4.4 (0.5) | 4.6 (0.6) | 0.1 |
Chlorine (mmol/L), mean (SD) | 100.2 (5) | 99 (4.2) | 99.6 (3.3) | 0.8 |
Calcium (mg/dL), mean (SD) | 9.3 (0.8) | 9 (0.4) | 9.2 (0.5) | 0.3 |
Phosphorus (mg/dL), mean (SD) | 4.8 (1.2) | 4.5 (1.1) | 4.7 (1.1) | 0.6 |
Magnesium (mg/dL), mean (SD) | 2 (0.5) | 2.2 (0.5) | 2.2 (0.5) | 0.7 |
HbA1c (%), mean (SD) | 6 (0.9) | 6 (0.7) | 5.9 (0.6) | 0.8 |
Uric acid (mg/dL), mean (SD) | 5.2 (1.4) | 5.1 (1.2) | 5.4 (1.3) | 0.5 |
Cholesterol (mg/dL), mean (SD) | 143.9 (29.5) | 148.8 (47.1) | 150.2 (47.8) | 0.9 |
Triglycerides (mg/dL), mean (SD) | 152.3 (81.5) | 163.5 (80) | 193.6 (213.9) | 0.7 |
HDL (mg/dL), mean (SD) | 50.1 (15.8) | 46.9 (14.5) | 43.5 (17.8) | 0.5 |
LDL (mg/dL), mean (SD) | 71.8 (17.2) | 70.2 (40.3) | 64.3 (27.2) | 0.6 |
Bilirubin (mg/dL), mean (SD) | 0.4 (0.2) | 0.4 (0.1) | 0.4 (0.2) | 0.6 |
AST (IU/L), mean (SD) | 20.9 (11.7) | 23.4 (22.1) | 20.5 (15.7) | 0.5 |
ALT (IU/L), mean (SD) | 24 (15.8) | 27.1 (27.3) | 20.5 (12.4) | 0.3 |
GGT (IU/L), mean (SD) | 28.2 (21.7) | 43.7 (55.3) | 36.7 (35.5) | 0.2 |
KT/V weekly (Lt), mean (SD) | 2.1 (0.4) | 2.1 (0.4) | 2 (0.4) | 0.5 |
nPCR (g Urea/Kg/d), mean (SD) | 0.9 (0.2) | 0.8 (0.1) | 0.8 (0.1) | 0.08 |
Ultrafiltration PD (mL/day), median [IQR] | 425 [250–600] | 500 [250–550] | 475 [250–700] | 0.8 |
KrU (mL/min), mean (SD) | 4.1 (2.5) | 3.7 (2.2) | 3.8 (2.7) | 0.5 |
Diuresis (mL/day), mean (SD) | 1521.9 (698.8) | 1448.5 (837.8) | 1402.5 (810) | 0.8 |
ClCr (mL/min), mean (SD) | 8.7 (5.5) | 7.5 (5.2) | 6.7 (5.2) | 0.2 |
(ClCr + KrU/2) (mL/min), mean (SD) | 6.4 (3.6) | 5.6 (3.6) | 5.3 (3.8) | 0.2 |
MAU 24 h (mg/24 h), median [IQR] | 283 [65.2–553] | 139.5 [42.3–300] | 114.6 [56.9–428.4] | 0.9 |
Proteinuria (mg/24 h), median [IQR] | 489.7 [192.6–1128] | 257.4 [180–500] | 328.6 [179–765.4] | 0.5 |
SBP (mmHg), mean (SD) | 139.8 (10.2) | 129.5 (5.2) | 129.7 (7.0) | 0.003 |
DBP (mmHg), mean (SD) | 71.4 (8.1) | 68.2 (6.8) | 71.8(5.9) | 0.06 |
Bicarbonate (mEq/L), mean (SD) | 22.1 (2.1) | 21.8 (1.3) | 21.4 (0.8) | 0.5 |
NoDM | DM | p-Value | |
---|---|---|---|
(N = 6) | (N = 6) | ||
KrU (mL/min), median [IQR] | −0.1 [−0.4 to 0.2] | 0.1 [0–0.6] | 0.5 |
ClCr (mL/min), median [IQR] | −1.1 [−1.6 to −0.7] | −0.3 [−3.1 to 2.1] | 0.5 |
Diuresis (mL), median [IQR] | 0 [−150 to 200] | −125 [−600 to 130] | 0.5 |
Ultrafiltration PD (mL/day), median [IQR] | 25 [−50 to 50] | 50 [0–200] | 0.5 |
HbA1c (%), median [IQR] | 0 [−0.07 to 0] | −0.04 [−0.5 to −0.3] | 0.04 |
Proteinuria (mg/24 h), median [IQR] | −15.3 [−40 to 440] | −266.3 [−2209.2 to −10.2] | 0.2 |
MAU (mg/24 h), median [IQR] | −26.9 [−20 to 28.9] | −189 [−1172.6 to −79] | 0.05 |
SBP (mmHg), median [IQR] | −15 [−20 to −7] | −5 [−8 to 2] | 0.1 |
DBP (mmHg), median [IQR] | 51 [51–51] | 64 [53–68] | 0.07 |
nPCR (g Urea/Kg/d), median [IQR] | −0.1 [−0.31 to 0.01] | −0.05 [−0.3 to 0.1] | 0.5 |
KT/V weekly (L), median [IQR] | 0 [−0.02 to 0] | −0.05 [−0.1 to 0] | 0.3 |
Dry weight (kg), median [IQR] | −0.8 [−2.2 to 0.4] | −2.4 [−3.6 to −1.1] | 0.1 |
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Moral Berrio, E.; De La Flor, J.C.; Arambarri Segura, M.; Rodríguez-Doyágüez, P.; Martínez Calero, A.; Zamora, R.; Cieza-Terrones, M.; Yuste-Lozano, C.; Sánchez de la Nieta García, M.D.; Nieto Iglesias, J.; et al. Effects of Sodium–Glucose Cotransporter 2 Inhibitors in Diabetic and Non-Diabetic Patients with Advanced Chronic Kidney Disease in Peritoneal Dialysis on Residual Kidney Function: In Real-World Data. Medicina 2024, 60, 1198. https://doi.org/10.3390/medicina60081198
Moral Berrio E, De La Flor JC, Arambarri Segura M, Rodríguez-Doyágüez P, Martínez Calero A, Zamora R, Cieza-Terrones M, Yuste-Lozano C, Sánchez de la Nieta García MD, Nieto Iglesias J, et al. Effects of Sodium–Glucose Cotransporter 2 Inhibitors in Diabetic and Non-Diabetic Patients with Advanced Chronic Kidney Disease in Peritoneal Dialysis on Residual Kidney Function: In Real-World Data. Medicina. 2024; 60(8):1198. https://doi.org/10.3390/medicina60081198
Chicago/Turabian StyleMoral Berrio, Esperanza, José C. De La Flor, Minerva Arambarri Segura, Pablo Rodríguez-Doyágüez, Alberto Martínez Calero, Rocío Zamora, Michael Cieza-Terrones, Claudia Yuste-Lozano, María Dolores Sánchez de la Nieta García, Javier Nieto Iglesias, and et al. 2024. "Effects of Sodium–Glucose Cotransporter 2 Inhibitors in Diabetic and Non-Diabetic Patients with Advanced Chronic Kidney Disease in Peritoneal Dialysis on Residual Kidney Function: In Real-World Data" Medicina 60, no. 8: 1198. https://doi.org/10.3390/medicina60081198