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钠-葡萄糖协同转运蛋白2抑制剂与造影剂诱导的肾病风险:一项荟萃分析。

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

作者信息

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

机构信息

Cardiology Department of Xianyang Central Hospital, Xianyang, Shaanxi Province, 712000, People's Republic of China.

Shaanxi University of Chinese Medicine, Xianyang, Shaanxi Province, 712046, People's Republic of China.

出版信息

Eur J Clin Pharmacol. 2025 Mar;81(3):337-345. doi: 10.1007/s00228-024-03799-y. Epub 2024 Dec 27.

Abstract

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, I = 0%) and mortality (OR 0.45, 95% CI (0.26, 0.77), P = 0.0039, I = 48%). No notable discrepancy was discerned in continuous renal replacement therapy (CRRT) (OR 0.53, 95% CI (0.15, 1.91), I = 0%) or contrast volume (MD - 9.68, 95% CI (- 19.38, 0.03), I = 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.

摘要

背景

造影剂肾病(CIN)是在进行诊断性检查或治疗性血管造影干预时使用造影剂后发生的不良肾脏事件。然而,除了水化治疗外,目前尚无有效且安全的治疗CIN的药物。我们旨在进行一项荟萃分析,以验证钠-葡萄糖协同转运蛋白2抑制剂(SGLT2is)在预防CIN方面的潜在肾脏保护作用。

方法

检索了PubMed、Web of Science和中国知网(CNKI)数据库,检索时间从各数据库创建之日至2024年8月26日。使用R和Stata软件的“Meta”包进行数据分析。

结果

分析共纳入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可显著降低CIN(比值比(OR)0.39,95%置信区间(CI)(0.31,0.48),P<0.0001,I=0%)和死亡率(OR 0.45,95%CI(0.26,0.77),P=0.0039,I=48%)。在持续肾脏替代治疗(CRRT)(OR 0.53,95%CI(0.15,1.91),I=0%)或造影剂用量(MD -9.68,95%CI(-19.38,0.03),I=71%)方面未发现明显差异。

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。建议未来进行大规模随机对照试验(RCT)以证实这些发现,并进一步阐明非糖尿病患者的治疗结果。

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