Relation between Blood Pressure Management and Renal Effects of Sodium-Glucose Cotransporter 2 Inhibitors in Diabetic Patients with Chronic Kidney Disease

Kazuo Kobayashi; Masao Toyoda; Noriko Kaneyama; Nobuo Hatori; Takayuki Furuki; Hiroyuki Sakai; Masahiro Takihata; Tomoya Umezono; Shun Ito; Daisuke Suzuki; Hiroshi Takeda; Akira Kanamori; Hisakazu Degawa; Hareaki Yamamoto; Hideo Machimura; Atsuko Mokubo; Keiichi Chin; Mitsuo Obana; Toshimasa Hishiki; Kouta Aoyama; Shinichi Nakajima; Shinichi Umezawa; Hidetoshi Shimura; Togo Aoyama; Masaaki Miyakawa

doi:10.1155/2019/9415313

Journal of Diabetes Research (Jan 2019)

Relation between Blood Pressure Management and Renal Effects of Sodium-Glucose Cotransporter 2 Inhibitors in Diabetic Patients with Chronic Kidney Disease

Kazuo Kobayashi,
Masao Toyoda,
Noriko Kaneyama,
Nobuo Hatori,
Takayuki Furuki,
Hiroyuki Sakai,
Masahiro Takihata,
Tomoya Umezono,
Shun Ito,
Daisuke Suzuki,
Hiroshi Takeda,
Akira Kanamori,
Hisakazu Degawa,
Hareaki Yamamoto,
Hideo Machimura,
Atsuko Mokubo,
Keiichi Chin,
Mitsuo Obana,
Toshimasa Hishiki,
Kouta Aoyama,
Shinichi Nakajima,
Shinichi Umezawa,
Hidetoshi Shimura,
Togo Aoyama,
Masaaki Miyakawa

Affiliations

Kazuo Kobayashi: Committee of Hypertension and Kidney Disease, Kanagawa Physicians Association, Yokohama, Kanagawa Prefecture, Japan
Masao Toyoda: Committee of Hypertension and Kidney Disease, Kanagawa Physicians Association, Yokohama, Kanagawa Prefecture, Japan
Noriko Kaneyama: Committee of Hypertension and Kidney Disease, Kanagawa Physicians Association, Yokohama, Kanagawa Prefecture, Japan
Nobuo Hatori: Committee of Hypertension and Kidney Disease, Kanagawa Physicians Association, Yokohama, Kanagawa Prefecture, Japan
Takayuki Furuki: Committee of Hypertension and Kidney Disease, Kanagawa Physicians Association, Yokohama, Kanagawa Prefecture, Japan
Hiroyuki Sakai: Committee of Hypertension and Kidney Disease, Kanagawa Physicians Association, Yokohama, Kanagawa Prefecture, Japan
Masahiro Takihata: Committee of Hypertension and Kidney Disease, Kanagawa Physicians Association, Yokohama, Kanagawa Prefecture, Japan
Tomoya Umezono: Committee of Hypertension and Kidney Disease, Kanagawa Physicians Association, Yokohama, Kanagawa Prefecture, Japan
Shun Ito: Committee of Hypertension and Kidney Disease, Kanagawa Physicians Association, Yokohama, Kanagawa Prefecture, Japan
Daisuke Suzuki: Committee of Hypertension and Kidney Disease, Kanagawa Physicians Association, Yokohama, Kanagawa Prefecture, Japan
Hiroshi Takeda: Committee of Hypertension and Kidney Disease, Kanagawa Physicians Association, Yokohama, Kanagawa Prefecture, Japan
Akira Kanamori: Committee of Hypertension and Kidney Disease, Kanagawa Physicians Association, Yokohama, Kanagawa Prefecture, Japan
Hisakazu Degawa: Committee of Hypertension and Kidney Disease, Kanagawa Physicians Association, Yokohama, Kanagawa Prefecture, Japan
Hareaki Yamamoto: Committee of Hypertension and Kidney Disease, Kanagawa Physicians Association, Yokohama, Kanagawa Prefecture, Japan
Hideo Machimura: Committee of Hypertension and Kidney Disease, Kanagawa Physicians Association, Yokohama, Kanagawa Prefecture, Japan
Atsuko Mokubo: Committee of Hypertension and Kidney Disease, Kanagawa Physicians Association, Yokohama, Kanagawa Prefecture, Japan
Keiichi Chin: Committee of Hypertension and Kidney Disease, Kanagawa Physicians Association, Yokohama, Kanagawa Prefecture, Japan
Mitsuo Obana: Committee of Hypertension and Kidney Disease, Kanagawa Physicians Association, Yokohama, Kanagawa Prefecture, Japan
Toshimasa Hishiki: Committee of Hypertension and Kidney Disease, Kanagawa Physicians Association, Yokohama, Kanagawa Prefecture, Japan
Kouta Aoyama: Committee of Hypertension and Kidney Disease, Kanagawa Physicians Association, Yokohama, Kanagawa Prefecture, Japan
Shinichi Nakajima: Committee of Hypertension and Kidney Disease, Kanagawa Physicians Association, Yokohama, Kanagawa Prefecture, Japan
Shinichi Umezawa: Committee of Hypertension and Kidney Disease, Kanagawa Physicians Association, Yokohama, Kanagawa Prefecture, Japan
Hidetoshi Shimura: Committee of Hypertension and Kidney Disease, Kanagawa Physicians Association, Yokohama, Kanagawa Prefecture, Japan
Togo Aoyama: Committee of Hypertension and Kidney Disease, Kanagawa Physicians Association, Yokohama, Kanagawa Prefecture, Japan
Masaaki Miyakawa: Committee of Hypertension and Kidney Disease, Kanagawa Physicians Association, Yokohama, Kanagawa Prefecture, Japan

DOI: https://doi.org/10.1155/2019/9415313
Journal volume & issue: Vol. 2019

Abstract

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Aim. The renoprotective effect of sodium-glucose cotransporter 2 inhibitors is thought to be due, at least in part, to a decrease in blood pressure. The aim of this study was to determine the renal effects of these inhibitors in low blood pressure patients and the dependence of such effect on blood pressure management status. Methods. The subjects of this retrospective study were 740 patients with type 2 diabetes mellitus and chronic kidney disease who had been managed at the clinical facilities of the Kanagawa Physicians Association. Data on blood pressure management status and urinary albumin-creatinine ratio were analyzed before and after treatment. Results. Changes in the logarithmic value of urinary albumin-creatinine ratio in 327 patients with blood pressure<130/80 mmHg at the initiation of treatment and in 413 patients with BP above 130/80 mmHg were −0.13±1.05 and −0.24±0.97, respectively. However, there was no significant difference between the two groups by analysis of covariance models after adjustment of the logarithmic value of urinary albumin-creatinine ratio at initiation of treatment. Changes in the logarithmic value of urinary albumin-creatinine ratio in patients with mean blood pressure of <102 mmHg (n=537) and those with ≥102 mmHg (n=203) at the time of the survey were −0.25±1.02 and −0.03±0.97, respectively, and the difference was significant in analysis of covariance models even after adjustment for the logarithmic value of urinary albumin-creatinine ratio at initiation of treatment (p<0.001). Conclusion. Our results confirmed that blood pressure management status after treatment with SGLT2 inhibitors influences the extent of change in urinary albumin-creatinine ratio. Stricter blood pressure management is needed to allow the renoprotective effects of sodium-glucose cotransporter 2 inhibitors.

Published in Journal of Diabetes Research

ISSN: 2314-6745 (Print); 2314-6753 (Online)
Publisher: Wiley
Country of publisher: United Kingdom
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the endocrine glands. Clinical endocrinology
Website: https://onlinelibrary.wiley.com/journal/1485

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