Nephroprotective Effects of Dapagliflozin in Patients with Type 2 Diabetes
Objective This study analyzed changes in the estimated glomerular filtration rate calculated using cystatin C (eGFRcys) and sodium excretion in the urine after administering dapagliflozin as an add-on therapy to conventional treatment for diabetes. Methods This was a single-center, single-group, pro...
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| Veröffentlicht in: | Internal Medicine 2023/03/01, Vol.62(5), pp.681-688 |
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| creator | Iijima, Yasuhiro Nakayama, Masafumi Miwa, Takashi Yakou, Fumiyoshi Tomiyama, Hirofumi Shikuma, Junpei Ito, Rokuro Tanaka, Akihiko Manda, Naoki Odawara, Masato |
| description | Objective This study analyzed changes in the estimated glomerular filtration rate calculated using cystatin C (eGFRcys) and sodium excretion in the urine after administering dapagliflozin as an add-on therapy to conventional treatment for diabetes. Methods This was a single-center, single-group, prospective interventional study. Dapagliflozin was administered to improve the plasma glucose control in 30 subjects with type 2 diabetes mellitus (age 53±8 years old; 66.6% men). Blood and urine tests were performed before and 6 and 12 months after dapagliflozin administration. The daily sodium excretion was estimated with the Kawasaki formula using second-morning urine samples. Results The eGFRcys did not markedly differ before and 6 months after the dapagliflozin administration but was significantly increased after 12 months (p |
| doi_str_mv | 10.2169/internalmedicine.6685-20 |
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| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10037009</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2781622911</sourcerecordid><originalsourceid>FETCH-LOGICAL-c555t-bc1368ad1703a776c54838e464602f8b821a255536c38d980e920348f34fcebd3</originalsourceid><addsrcrecordid>eNptkdtOGzEQhi1EVdLQV0Ar9YabpT7s-nBVVRx6EAIu6LXldcaJo816azsgeHqcJo1ahGSNLc3nf2b-Qagi-IwSrj77IUMcTL-Cmbd-gDPOZVtTfIAmhDWqFpS1h2iCFZE1LeEIfUhpiTGTQtH36IgVXHKiJujnDYyLGMYYMtjsH6C6dK68UhVcdWFGM--968OzH6py7kz2MJTko8-L6v5phIpWF950kCEdo3fO9Ak-7u4p-nV1eX_-vb6-_fbj_Ot1bdu2zXVnSSlvZkRgZoTgtm0kk9DwhmPqZCcpMbSQjFsmZ0piUBSzRjrWOAvdjE3Rl63uuO6KAbY0FE2vx-hXJj7pYLz-PzP4hZ6HB02KAQJjVRROdwox_F5Dynrlk4W-NwOEddJUSMJpMY4U9NMrdBnWG-v_UFwQoRQvlNxSNoaUIrh9NwTrzcb0643pzcZ0GWyKTv6dZv_x74oKcLMFlimbOewBE7O3PbyhTHW7CbsKe9AuTNQwsBcgBrQf</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2786717996</pqid></control><display><type>article</type><title>Nephroprotective Effects of Dapagliflozin in Patients with Type 2 Diabetes</title><source>J-STAGE Free</source><source>MEDLINE</source><source>PubMed Central Open Access</source><source>PubMed Central</source><creator>Iijima, Yasuhiro ; Nakayama, Masafumi ; Miwa, Takashi ; Yakou, Fumiyoshi ; Tomiyama, Hirofumi ; Shikuma, Junpei ; Ito, Rokuro ; Tanaka, Akihiko ; Manda, Naoki ; Odawara, Masato</creator><creatorcontrib>Iijima, Yasuhiro ; Nakayama, Masafumi ; Miwa, Takashi ; Yakou, Fumiyoshi ; Tomiyama, Hirofumi ; Shikuma, Junpei ; Ito, Rokuro ; Tanaka, Akihiko ; Manda, Naoki ; Odawara, Masato</creatorcontrib><description>Objective This study analyzed changes in the estimated glomerular filtration rate calculated using cystatin C (eGFRcys) and sodium excretion in the urine after administering dapagliflozin as an add-on therapy to conventional treatment for diabetes. Methods This was a single-center, single-group, prospective interventional study. Dapagliflozin was administered to improve the plasma glucose control in 30 subjects with type 2 diabetes mellitus (age 53±8 years old; 66.6% men). Blood and urine tests were performed before and 6 and 12 months after dapagliflozin administration. The daily sodium excretion was estimated with the Kawasaki formula using second-morning urine samples. Results The eGFRcys did not markedly differ before and 6 months after the dapagliflozin administration but was significantly increased after 12 months (p<0.001), and the estimated daily sodium excretion was also significantly increased (p<0.001 at 6 months and p=0.002 at 12 months). The systolic and diastolic blood pressures tended to decrease after administration. The HbA1c level after the administration of dapagliflozin tended to be lower in the T3 group, showing the smallest increase in changes in the estimated daily sodium excretion from baseline to 6 months (28.2-107.5 mEq/day), than in the combined groups of T1 (219.5-110.1 mEq/day) and T2 (101.4-28.9 mEq/day). In contrast, the eGFRcys was significantly higher in the combined groups of T1 and T2 than that in the T3 group at both 6 and 12 months (p=0.031 and p=0.007, respectively). Conclusions Add-on therapy with dapagliflozin increased the urinary sodium excretion and decreased the blood pressure even in the early phase of this therapy. Our results suggest that dapagliflozin add-on therapy may exert nephroprotective effects in subjects with type 2 diabetes mellitus.</description><identifier>ISSN: 0918-2918</identifier><identifier>EISSN: 1349-7235</identifier><identifier>DOI: 10.2169/internalmedicine.6685-20</identifier><identifier>PMID: 36858619</identifier><language>eng</language><publisher>Japan: The Japanese Society of Internal Medicine</publisher><subject>Benzhydryl Compounds ; Blood pressure ; Cystatin C ; dapagliflozin ; Diabetes ; diabetes mellitus ; Diabetes mellitus (non-insulin dependent) ; Diabetes Mellitus, Type 2 ; Excretion ; Female ; Glomerular filtration rate ; Glucosides ; Humans ; Internal medicine ; Male ; Middle Aged ; nephroprotective effects ; Original ; Prospective Studies ; Sodium ; sodium excretion ; sodium glucose cotransporter-2 ; Urine</subject><ispartof>Internal Medicine, 2023/03/01, Vol.62(5), pp.681-688</ispartof><rights>2023 by The Japanese Society of Internal Medicine</rights><rights>Copyright Japan Science and Technology Agency 2023</rights><rights>Copyright © 2023 by The Japanese Society of Internal Medicine</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c555t-bc1368ad1703a776c54838e464602f8b821a255536c38d980e920348f34fcebd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10037009/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10037009/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,1876,27903,27904,53769,53771</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36858619$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Iijima, Yasuhiro</creatorcontrib><creatorcontrib>Nakayama, Masafumi</creatorcontrib><creatorcontrib>Miwa, Takashi</creatorcontrib><creatorcontrib>Yakou, Fumiyoshi</creatorcontrib><creatorcontrib>Tomiyama, Hirofumi</creatorcontrib><creatorcontrib>Shikuma, Junpei</creatorcontrib><creatorcontrib>Ito, Rokuro</creatorcontrib><creatorcontrib>Tanaka, Akihiko</creatorcontrib><creatorcontrib>Manda, Naoki</creatorcontrib><creatorcontrib>Odawara, Masato</creatorcontrib><title>Nephroprotective Effects of Dapagliflozin in Patients with Type 2 Diabetes</title><title>Internal Medicine</title><addtitle>Intern. Med.</addtitle><description>Objective This study analyzed changes in the estimated glomerular filtration rate calculated using cystatin C (eGFRcys) and sodium excretion in the urine after administering dapagliflozin as an add-on therapy to conventional treatment for diabetes. Methods This was a single-center, single-group, prospective interventional study. Dapagliflozin was administered to improve the plasma glucose control in 30 subjects with type 2 diabetes mellitus (age 53±8 years old; 66.6% men). Blood and urine tests were performed before and 6 and 12 months after dapagliflozin administration. The daily sodium excretion was estimated with the Kawasaki formula using second-morning urine samples. Results The eGFRcys did not markedly differ before and 6 months after the dapagliflozin administration but was significantly increased after 12 months (p<0.001), and the estimated daily sodium excretion was also significantly increased (p<0.001 at 6 months and p=0.002 at 12 months). The systolic and diastolic blood pressures tended to decrease after administration. The HbA1c level after the administration of dapagliflozin tended to be lower in the T3 group, showing the smallest increase in changes in the estimated daily sodium excretion from baseline to 6 months (28.2-107.5 mEq/day), than in the combined groups of T1 (219.5-110.1 mEq/day) and T2 (101.4-28.9 mEq/day). In contrast, the eGFRcys was significantly higher in the combined groups of T1 and T2 than that in the T3 group at both 6 and 12 months (p=0.031 and p=0.007, respectively). Conclusions Add-on therapy with dapagliflozin increased the urinary sodium excretion and decreased the blood pressure even in the early phase of this therapy. Our results suggest that dapagliflozin add-on therapy may exert nephroprotective effects in subjects with type 2 diabetes mellitus.</description><subject>Benzhydryl Compounds</subject><subject>Blood pressure</subject><subject>Cystatin C</subject><subject>dapagliflozin</subject><subject>Diabetes</subject><subject>diabetes mellitus</subject><subject>Diabetes mellitus (non-insulin dependent)</subject><subject>Diabetes Mellitus, Type 2</subject><subject>Excretion</subject><subject>Female</subject><subject>Glomerular filtration rate</subject><subject>Glucosides</subject><subject>Humans</subject><subject>Internal medicine</subject><subject>Male</subject><subject>Middle Aged</subject><subject>nephroprotective effects</subject><subject>Original</subject><subject>Prospective Studies</subject><subject>Sodium</subject><subject>sodium excretion</subject><subject>sodium glucose cotransporter-2</subject><subject>Urine</subject><issn>0918-2918</issn><issn>1349-7235</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNptkdtOGzEQhi1EVdLQV0Ar9YabpT7s-nBVVRx6EAIu6LXldcaJo816azsgeHqcJo1ahGSNLc3nf2b-Qagi-IwSrj77IUMcTL-Cmbd-gDPOZVtTfIAmhDWqFpS1h2iCFZE1LeEIfUhpiTGTQtH36IgVXHKiJujnDYyLGMYYMtjsH6C6dK68UhVcdWFGM--968OzH6py7kz2MJTko8-L6v5phIpWF950kCEdo3fO9Ak-7u4p-nV1eX_-vb6-_fbj_Ot1bdu2zXVnSSlvZkRgZoTgtm0kk9DwhmPqZCcpMbSQjFsmZ0piUBSzRjrWOAvdjE3Rl63uuO6KAbY0FE2vx-hXJj7pYLz-PzP4hZ6HB02KAQJjVRROdwox_F5Dynrlk4W-NwOEddJUSMJpMY4U9NMrdBnWG-v_UFwQoRQvlNxSNoaUIrh9NwTrzcb0643pzcZ0GWyKTv6dZv_x74oKcLMFlimbOewBE7O3PbyhTHW7CbsKe9AuTNQwsBcgBrQf</recordid><startdate>20230301</startdate><enddate>20230301</enddate><creator>Iijima, Yasuhiro</creator><creator>Nakayama, Masafumi</creator><creator>Miwa, Takashi</creator><creator>Yakou, Fumiyoshi</creator><creator>Tomiyama, Hirofumi</creator><creator>Shikuma, Junpei</creator><creator>Ito, Rokuro</creator><creator>Tanaka, Akihiko</creator><creator>Manda, Naoki</creator><creator>Odawara, Masato</creator><general>The Japanese Society of Internal Medicine</general><general>Japan Science and Technology Agency</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>7U9</scope><scope>H94</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20230301</creationdate><title>Nephroprotective Effects of Dapagliflozin in Patients with Type 2 Diabetes</title><author>Iijima, Yasuhiro ; Nakayama, Masafumi ; Miwa, Takashi ; Yakou, Fumiyoshi ; Tomiyama, Hirofumi ; Shikuma, Junpei ; Ito, Rokuro ; Tanaka, Akihiko ; Manda, Naoki ; Odawara, Masato</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c555t-bc1368ad1703a776c54838e464602f8b821a255536c38d980e920348f34fcebd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Benzhydryl Compounds</topic><topic>Blood pressure</topic><topic>Cystatin C</topic><topic>dapagliflozin</topic><topic>Diabetes</topic><topic>diabetes mellitus</topic><topic>Diabetes mellitus (non-insulin dependent)</topic><topic>Diabetes Mellitus, Type 2</topic><topic>Excretion</topic><topic>Female</topic><topic>Glomerular filtration rate</topic><topic>Glucosides</topic><topic>Humans</topic><topic>Internal medicine</topic><topic>Male</topic><topic>Middle Aged</topic><topic>nephroprotective effects</topic><topic>Original</topic><topic>Prospective Studies</topic><topic>Sodium</topic><topic>sodium excretion</topic><topic>sodium glucose cotransporter-2</topic><topic>Urine</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Iijima, Yasuhiro</creatorcontrib><creatorcontrib>Nakayama, Masafumi</creatorcontrib><creatorcontrib>Miwa, Takashi</creatorcontrib><creatorcontrib>Yakou, Fumiyoshi</creatorcontrib><creatorcontrib>Tomiyama, Hirofumi</creatorcontrib><creatorcontrib>Shikuma, Junpei</creatorcontrib><creatorcontrib>Ito, Rokuro</creatorcontrib><creatorcontrib>Tanaka, Akihiko</creatorcontrib><creatorcontrib>Manda, Naoki</creatorcontrib><creatorcontrib>Odawara, Masato</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Internal Medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Iijima, Yasuhiro</au><au>Nakayama, Masafumi</au><au>Miwa, Takashi</au><au>Yakou, Fumiyoshi</au><au>Tomiyama, Hirofumi</au><au>Shikuma, Junpei</au><au>Ito, Rokuro</au><au>Tanaka, Akihiko</au><au>Manda, Naoki</au><au>Odawara, Masato</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Nephroprotective Effects of Dapagliflozin in Patients with Type 2 Diabetes</atitle><jtitle>Internal Medicine</jtitle><addtitle>Intern. Med.</addtitle><date>2023-03-01</date><risdate>2023</risdate><volume>62</volume><issue>5</issue><spage>681</spage><epage>688</epage><pages>681-688</pages><artnum>6685-20</artnum><issn>0918-2918</issn><eissn>1349-7235</eissn><abstract>Objective This study analyzed changes in the estimated glomerular filtration rate calculated using cystatin C (eGFRcys) and sodium excretion in the urine after administering dapagliflozin as an add-on therapy to conventional treatment for diabetes. Methods This was a single-center, single-group, prospective interventional study. Dapagliflozin was administered to improve the plasma glucose control in 30 subjects with type 2 diabetes mellitus (age 53±8 years old; 66.6% men). Blood and urine tests were performed before and 6 and 12 months after dapagliflozin administration. The daily sodium excretion was estimated with the Kawasaki formula using second-morning urine samples. Results The eGFRcys did not markedly differ before and 6 months after the dapagliflozin administration but was significantly increased after 12 months (p<0.001), and the estimated daily sodium excretion was also significantly increased (p<0.001 at 6 months and p=0.002 at 12 months). The systolic and diastolic blood pressures tended to decrease after administration. The HbA1c level after the administration of dapagliflozin tended to be lower in the T3 group, showing the smallest increase in changes in the estimated daily sodium excretion from baseline to 6 months (28.2-107.5 mEq/day), than in the combined groups of T1 (219.5-110.1 mEq/day) and T2 (101.4-28.9 mEq/day). In contrast, the eGFRcys was significantly higher in the combined groups of T1 and T2 than that in the T3 group at both 6 and 12 months (p=0.031 and p=0.007, respectively). Conclusions Add-on therapy with dapagliflozin increased the urinary sodium excretion and decreased the blood pressure even in the early phase of this therapy. Our results suggest that dapagliflozin add-on therapy may exert nephroprotective effects in subjects with type 2 diabetes mellitus.</abstract><cop>Japan</cop><pub>The Japanese Society of Internal Medicine</pub><pmid>36858619</pmid><doi>10.2169/internalmedicine.6685-20</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Benzhydryl Compounds Blood pressure Cystatin C dapagliflozin Diabetes diabetes mellitus Diabetes mellitus (non-insulin dependent) Diabetes Mellitus, Type 2 Excretion Female Glomerular filtration rate Glucosides Humans Internal medicine Male Middle Aged nephroprotective effects Original Prospective Studies Sodium sodium excretion sodium glucose cotransporter-2 Urine |
| title | Nephroprotective Effects of Dapagliflozin in Patients with Type 2 Diabetes |
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