PMID- 31198224
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220408
IS  - 2048-8505 (Print)
IS  - 2048-8513 (Electronic)
IS  - 2048-8505 (Linking)
VI  - 12
IP  - 3
DP  - 2019 Jun
TI  - Effect of sodium-glucose cotransporter 2 inhibitor on proximal tubular function 
      and injury in patients with type 2 diabetes: a randomized controlled trial.
PG  - 326-332
LID - 10.1093/ckj/sfy122 [doi]
AB  - BACKGROUND: Intensive glucose control reduces the risk for microvascular 
      complications in type 2 diabetes (T2DM). Recently, sodium-glucose cotransporter 2 
      (SGLT2) inhibitors have been shown to exert renoprotection beyond glycemic 
      control, although their effects on the organs are not well known. There are 
      limited data on SGLT2 inhibitors for the biomarkers of kidney injury in type 2 
      diabetes mellitus (T2DM) patients. OBJECTIVE: Our objective was to demonstrate 
      the effect of SGLT2 inhibitors on proximal tubular injury and function in 
      patients with T2DM. METHODS: T2DM patients with persistent glycated hemoglobin 
      (HbA1c) levels >7% were randomly assigned to either dapagliflozin 10 mg/day 
      (n = 28) or standard treatment (n = 29) for 12 weeks. Proximal tubular injury 
      biomarkers, including urine kidney injury molecule-1:creatinine ratio (UKIM1CR), 
      urine cystatin C:creatinine ratio (UCCR), urine albumin:creatinine ratio (UACR), 
      fractional excretion of phosphate (FEPO(4)) and fractional excretion of uric acid 
      (FEUA) were measured at baseline and study end. RESULTS: Baseline characteristics 
      were comparable between treatment groups. After 12 weeks, dapagliflozin-treated 
      versus standard-treated patients showed reductions in HbA1c (-0.75 +/- 0.21 versus 
      -0.70 +/- 0.25%; P = 0.882). There were significant between-group differences in 
      the reduction in UACR -23.3 [95% confidence interval (CI) -44.4 to -2.2] versus 
      +19.9 (-4.0-43.8) mg/g Cr; P = 0.010 and UKIM1CR [-26.7 (95% CI -232.9-179.5) 
      versus +422.2 (46.7-797.7) ng/g Cr; P = 0.047], but no significant difference in 
      changes in UCCR between the two groups. There was no significant change in 
      glomerular filtration rate, serum phosphate level, FEUA and FEPO(4) in the 
      dapagliflozin group. No serious renal-related adverse events were observed in 
      either group. CONCLUSIONS: This study indicates that dapagliflozin in T2DM 
      patients can decrease the levels of urinary proximal tubular injury biomarkers, 
      thus highlighting its renoprotective effect. SGLT2 inhibitors could prove useful 
      in treating T2DM by protecting against renal tubular injury and may lead to 
      reduced long-term renal outcomes.
FAU - Satirapoj, Bancha
AU  - Satirapoj B
AUID- ORCID: 0000-0002-8881-0942
AD  - Division of Nephrology, Department of Medicine, Phramongkutklao Hospital and 
      College of Medicine, Bangkok, Thailand.
FAU - Korkiatpitak, Pattharamon
AU  - Korkiatpitak P
AD  - Division of Nephrology, Department of Medicine, Phramongkutklao Hospital and 
      College of Medicine, Bangkok, Thailand.
FAU - Supasyndh, Ouppatham
AU  - Supasyndh O
AD  - Division of Nephrology, Department of Medicine, Phramongkutklao Hospital and 
      College of Medicine, Bangkok, Thailand.
LA  - eng
PT  - Journal Article
DEP - 20190104
PL  - England
TA  - Clin Kidney J
JT  - Clinical kidney journal
JID - 101579321
CIN - doi: 10.1093/ckj/sfz019
PMC - PMC6543969
OTO - NOTNLM
OT  - cystatin C
OT  - dapagliflozin
OT  - kidney injury molecule-1
OT  - sodium-glucose cotransporter 2 inhibitor
OT  - type 2 diabetes
EDAT- 2019/06/15 06:00
MHDA- 2019/06/15 06:01
PMCR- 2019/01/04
CRDT- 2019/06/15 06:00
PHST- 2018/07/03 00:00 [received]
PHST- 2019/06/15 06:00 [entrez]
PHST- 2019/06/15 06:00 [pubmed]
PHST- 2019/06/15 06:01 [medline]
PHST- 2019/01/04 00:00 [pmc-release]
AID - sfy122 [pii]
AID - 10.1093/ckj/sfy122 [doi]
PST - epublish
SO  - Clin Kidney J. 2019 Jan 4;12(3):326-332. doi: 10.1093/ckj/sfy122. eCollection 
      2019 Jun.