摘要
糖尿病肾病(DN)是导致终末期肾病的最常见原因之一。正常肾脏能重新吸收几乎所有滤过的葡萄糖,对维持葡萄糖稳态至关重要。在糖尿病中,过量的葡萄糖被肾脏滤过,导致葡萄糖吸收增加和高血糖。长期高血糖通过诱导肾脏的代谢和血流动力学变化促进DN的发展。钠-葡萄糖协同转运蛋白2(SGLT-2)抑制剂是一种新型的口服降糖药,作用于肾近端小管,抑制葡萄糖重吸收并增加尿葡萄糖排泄。大量的临床试验表明SGLT-2抑制剂不但可以降低血糖,还可以通过影响肾脏损伤的潜在机制来延缓肾脏疾病的进展。但是这类药物是否也可以安全、有效地用于各种程度肾功能损害的治疗仍需要慎重的考虑。
Diabetic nephropathy（DN） is the most common cause of end stage renal disease.It＇ s known that healthy renal function is crucial in maintaining glucose homeostasis,assuring that almost all of the filtered glucose is reabsorbed.In diabetes,an increased amount of glucose is filtered by the kidneys.Prolonged hyperglycemia contributes to the development of DN by inducing metabolic and hemodynamic changes in the kidneys.Sodium-glucose-linked transporter（SGLT） 2 inhibitor,a novel oral hypoglycemic agent,acts on renal proximal tubules,suppresses glucose reabsorption and increases urinary glucose excretion.A large number of clinical trials have shown that,besides lowering blood glucose level,SGLT-2 inhibitor can also help slow the progression of renal disease by impacting the underlying mechanisms of kidney injury.However,a major consideration is whether these new drugs can also be used safely and effectively across the spectrum of renal impairment.
作者
谷庆炜
李倩
GU Qingwei;LI Qian(Department of Endocrinology,Nanjing First Hospital,Nanjing Medical University,Nanjing 210006,China)
出处
《医学综述》
2018年第17期3447-3451,共5页
Medical Recapitulate
基金
江苏省自然科学基金(BK20171121)
