23例GLP-1受体激动剂致急性肾损伤不良反应文献分析

Literature Analysis of Acute Kidney Injury Caused by GLP-1 Receptor Agonists in 23 Cases

目的 分析GLP-1受体激动剂致急性肾损伤的临床表现、特点、规律及转归,为临床安全用药提供参考。方法 计算机检索自建库至2022年6月中国知网、维普中文科技期刊数据库、万方数据库、PubMed、Embase、Cochrane图书馆关于GLP-1受体激动剂致急性肾损伤个案报道,采用回顾性分析方法,对纳入病例中患者信息、ADR发生时间累及系统临床表现和转归等进行统计分析。结果 GLP-1受体激动剂致急性肾损伤的个案报道共23例(女性11例,45.83%;男性12例,54.17%);患者年龄以45~64岁年龄段较多(13例,56.52%);不良反应多发生在用药1月左右(11例,54.17%);GLP-1受体激动剂致急性肾损伤主要以泌尿系统损害(30例,44.12%)及胃肠系统损害(25例,36.76%)为主;20例经停药和/或对症支持治疗后症状治愈或好转;1例患者停药治疗后好转,再次用药后不良反应再现。结论 临床使用GLP-1受体激动剂时应慎重评估相关危险因素,尤其是对胃肠道反应较严重、合并用药较多、有相关肾脏疾病病史的老年患者需要调整药物使用剂量时,应加强对其肾功能的监测。

OBJECTIVE To analyze the clinical manifestations,characteristics,regularity and outcomes of acute kidney injury caused by GLP-1 receptor agonists,and to provide a reference for clinical safe drug use.METHODS Computer searched from library to June 2022 CNKI,VIP-Chinese Scientific and Technological Journal database,Wanfang database,PubMed,Embase,Cochrane library on GLP-1 receptor agonist acute kidney injury report.The patients included in the case information,ADR time involving system clinical performance and outcome of statistical analysis were used by retrospective analysis method.RESULTSS A total of 23 cases of GLP-1 receptor-agonist-induced acute kidney injury were reported(11 cases of female,45.83%and 12 cases of male,54.17%).The age distribution of patients were more from 45 to 64 years old(n=13,56.52%).Adverse reactions mostly occurred around January(n=11,54.17%).Acute kidney injury caused by GLP-1 receptor agonist were mainly caused by urinary system damage(n=30,44.12%)and gastrointestinal system damage(n=25,36.76%).20 symptoms were cured or improved after drug discontinuation and/or symptomatic supportive treatment.Adverse reactions happened in one patient again for redosing receptor agonist,after discontinuation and cure.CONCLUSION Relevant risk factors should be evaluated carefully when using GLP-1 receptor agonists clinically,especially the monitoring of renal function in elderly patients with severe gastrointestinal reactions,more combined drugs and a history of related renal disease who need to adjust the dose of drugs.