中止
医学
达帕格列嗪
封锁
内科学
糖尿病
内分泌学
2型糖尿病
受体
作者
Robert A. Fletcher,Niels Jongs,Glenn M. Chertow,John J.V. McMurray,Clare Arnott,Meg Jardine,Kenneth W. Mahaffey,Vlado Perkovic,Patrick Rockenschaub,Peter Rossing,Ricardo Correa‐Rotter,Robert D. Toto,Muthiah Vaduganathan,David C. Wheeler,Hiddo J.L. Heerspink,Brendon L. Neuen
出处
期刊:Journal of The American Society of Nephrology
日期:2023-10-25
卷期号:34 (12): 1965-1975
被引量:6
标识
DOI:10.1681/asn.0000000000000248
摘要
Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) are foundational therapy for CKD but are underused, in part because they are frequently withheld and not restarted due to hyperkalemia, AKI, or hospitalization. Consequently, ensuring persistent use of ACE inhibitors and ARBs in CKD has long been a major clinical priority. In this joint analysis of the CREDENCE and DAPA-CKD trials, the relative risk of discontinuation of ACE inhibitors and ARBs was reduced by 15% in patients randomized to sodium-glucose cotransporter 2 (SGLT2) inhibitors. This effect was more pronounced in patients with urine albumin:creatinine ratio ≥1000 mg/g, for whom the absolute benefits of these medications are the greatest. These findings indicate that SGLT2 inhibitors may enable better use of ACE inhibitors and ARBs in patients with CKD.
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