钠-葡萄糖转运体2抑制剂在慢性肾脏病患者临床应用的中国专家共识(2023年版)

Chinese expert consensus on the clinical application of sodium-glucose transporter 2 inhibitors in patients with chronic kidney disease(2023 edition)

钠-葡萄糖转运体2抑制剂(sodium-glucose transporter 2 inhibitors,SGLT2i)是一类新型口服降糖药,临床试验显示,该类药物不但对2型糖尿病患者有独立于降糖作用的心肾保护作用,而且对非糖尿病慢性肾脏病(chronic kidney disease,CKD)患者也可改善心肾结局,且总体安全性表现良好。目前SGLT2i已成为CKD患者心肾保护的重要治疗药物。为了更好地将相关的循证证据应用于临床实践,帮助广大医师在CKD管理中合理、规范地使用SGLT2i药物,该共识专家组基于现有的循证证据,综合肾脏病、内分泌和心血管领域专家的临床实践经验,组织多学科专家通过意见征询、投票及讨论会等方法反复商榷共同制订了该共识。共识内容涵盖SGLT2i建议使用人群、使用前不良反应风险评估、联合用药建议以及使用过程中的不良反应监测和处理等。

Sodium-glucose transporter 2(SGLT2)inhibitors are a novel type of oral hypoglycemic agent.Clinical trials have found that these drugs not only help control diabetes but also provide additional benefits for heart and kidney outcome.They have shown cardiorenal protection in patients with type 2 diabetes and can improve outcomes in non-diabetic patients with chronic kidney disease(CKD),and the overall safety performance is good.Therefore,SGLT2 inhibitors have become important drugs for cardiorenal protection in CKD patients.The consensus expert group undertook an extensive process to develop this consensus on the use of SGLT2 inhibitor drugs in managing CKD.They engaged multidisciplinary experts from nephrology,endocrinology,and cardiology to ensure a comprehensive and standardized approach.The expert group utilized existing evidence-based evidence and the expertise of the participating clinicians to formulate this consensus through consultation,voting and discussion.The consensus includes the recommended population for SGLT2 inhibitors use,the risk assessment of adverse reactions before use,the recommendation of combination administration,and the monitoring and management of adverse reactions during use.This collaborative effort aims to provide physicians with a reliable and practical framework for the rational use of SGLT2 inhibitor drugs in clinical practice.