Journal of Internal Medicine Concepts & Practice >
Effect of canagliflozin on urinary albumin / creatinine ratio and urinary podocyte-associated protein nephrin in patients with early diabetic kidney disease
Received date: 2020-10-16
Online published: 2022-07-25
Objective To investigate the effect of canagliflozin (sodium-glucose cotransporter 2 inhibitor, SGLT-2i) on the ratio of urine albumin-to-creatinine ratio(UACR) and urine podocyte-related protein nephrin in early diabetic nephropathy. Methods From January 2018 to July 2019, 116 patients with early diabetic nephropathy who were hospitalized in the Department of Endocrinology, Southern University of Science and Technology Hospital were enrolled. They were divided into canagliflozin group and control group with 1∶1 random number method. One hundred and five(90.5%) patients completed all studies, 51 were in the canagliflozin group and 54 were in the control group. The canagliflozin group was routinely given canagliflozin 100-300 mg/d, the control group received basal insulin and losartan potassium tablets 100 mg/d, and the patients in both groups were treated 24 weeks. The biochemical indicators of the patients were tested before treatment, 12-weeks and 24-weeks treatment. The UACR and the urine podocyte-associated protein nephrin before and after treatment were compared between groups and within groups. Results Compared with before treatment, both UACR and nephrin in the canagliflozin and the control groups improved after 12 weeks and 24 weeks treatment (P<0.05). Before treatment and after 12-weeks treatment, the UACR and nephrin indexes in canagliflozin and control groups didn’t show significant difference (P>0.05); while after 24-weeks treatment, these indexes in the canagliflozin group were significantly better than the control group(P<0.05). Conclusions Canagliflozin can continuously reduce the content of podocyte-associated protein nephrin in urine of early diabetic nephropathy. It is speculated that the renal protection of SGLT-2i drugs is independent of the effect of lowering the blood sugar.
SUN Yan, DAI Danjiao, CHEN Zhiwei, ZHANG Huaqing . Effect of canagliflozin on urinary albumin / creatinine ratio and urinary podocyte-associated protein nephrin in patients with early diabetic kidney disease[J]. Journal of Internal Medicine Concepts & Practice, 2021 , 16(06) : 387 -391 . DOI: 10.16138/j.1673-6087.2021.06.004
[1] | Audzeyenka I, Rogacka D, Piwkowska A, et al. Viability of primary cultured podocytes is associated with extracellular high glucose-dependent autophagy downregulation[J]. Mol Cell Biochem, 2017, 430(1-2): 11-19. |
[2] | 中华医学会内分泌学分会. 中国成人糖尿病肾脏病临床诊断的专家共识[J]. 中国内分泌代谢杂志, 2015, 31(5): 379-385. |
[3] | Kumar Pasupulati A, Chitra PS, Reddy GB. Advanced glycation end products mediated cellular and molecular events in the pathology of diabetic nephropathy[J]. Biomol Concepts, 2016, 7(5-6): 293-309. |
[4] | Perkovic V, Jardine MJ, Neal B, et al. Canagliflozin and renal outcomes in type 2 diabetes and nephropathy[J]. N Engl J Med, 2019, 380(24): 2295-2306. |
[5] | Li W, Du M, Wang Q, et al. FoxO1 promotes mitophagy in the podocytes of diabetic male mice via the PINK1/Parkin pathway[J]. Endocrinology, 2017, 158(7): 2155-2167. |
[6] | Lioudaki E, Stylianou KG, Petrakis I, et al. Increased urinary excretion of podocyte markers in normoalbuminuric patients with diabetes[J]. Nephron, 2015, 131(1): 34-42. |
[7] | 中华医学会糖尿病学分会. 中国2型糖尿病防治指南(2017年版)[J]. 中华糖尿病杂志, 2018, 10(4): 4-67. |
[8] | Koye DN, Magliano DJ, Reid CM, et al. Risk of progression of nonalbuminuric CKD to end-stage kidney disease in people with diabetes[J]. Am J Kidney Dis, 2018, 72(5): 653-661. |
[9] | Cho NH, Shaw JE, Karuranga S, et al. IDF diabetes atlas: global estimates of diabetes prevalence for 2017 and projections for 2045[J]. Diabetes Res Clin Pract, 2018, 138: 271-281. |
[10] | Ito Y, Hsu MF, Bettaieb A, et al. Protein tyrosine phosphatase 1B deficiency in podocytes mitigates hyperglycemia-induced renal injury[J]. Metabolism, 2017, 76: 56-69. |
[11] | Jiang XS, Chen XM, Wan JM, et al. Autophagy protects against palmitic acid-induced apoptosis in podocytes in vitro[J]. Sci Rep, 2017, 7: 42-64. |
[12] | Garofalo C, Borrelli S, Liberti ME, et al. SGLT2 inhibitors: nephroprotective efficacy and side effects[J]. Medicina (Kaunas), 2019, 55(6): E268. |
[13] | Lee YL, Chen BK, Lin KD, et al. The impact of severe hypoglycemia on renal impairment in type 2 diabetes[J]. Diabetes Res Clin Pract, 2015, 108(3): 448-455. |
[14] | Sakai S, Kaku K, Seino Y, et al. Efficacy and safety of the SGLT2 inhibitor luseogliflozin in Japanese patients with type 2 diabetes mellitus stratified according to baseline body mass index[J]. Clin Ther, 2016, 38(4): 843-862. |
[15] | 李宁, 高政南, 李欣宇, 等. 卡格列净联合胰岛素治疗肥胖或超重2型糖尿病患者的临床观察[J]. 中国慢性病预防与控制, 2019, 191(9): 66-68. |
[16] | Inagaki N, Harashima S, Maruyama N, et al. Efficacy and safety of canagliflozin in combination with insulin: a double-blind, randomized, placebo-controlled study in Japanese patients with type 2 diabetes mellitus[J]. Cardiovasc Diabetol, 2016, 15: 89. |
[17] | Yale JF, Bakris G, Cariou B, et al. Efficacy and safety of canagliflozin in subjects with type 2 diabetes and chronic kidney disease[J]. Diabetes Obes Metab, 2013, 15(5): 463-473. |
[18] | Zuo H, Wang S, Feng J, et al. BRD4 contributes to high-glucose-induced podocyte injury by modulating Keap1/Nrf2/ARE signaling[J]. Biochimie, 2019, 165: 100-107. |
[19] | 王荣珍, 姚灿, 刘沨. nephrin表达与糖尿病肾病预后相关性研究[J]. 临床荟萃, 2019, 34(5): 431-435. |
/
〈 |
|
〉 |