#3254 Effect of dapagliflozin on arterial stiffness and cognitive impairment in patients with chronic kidney disease
Notice bibliographique
Résumé
Abstract Background and Aims Sodium-glucose cotransporter-2 (SGLT2) inhibitors are a new class of antidiabetic agents that inhibit reabsorption of glucose and sodium in the proximal convoluted tubule. Many clinical studies have demonstrated their cardioprotective and nephroprotective effects in patients with chronic kidney disease (CKD). However, data regarding their effects on arterial stiffness and cognitive function remain rather limited. Method We studied 24 consecutive patients with CKD (stages 1–4), in whom dapagliflozin, 10mg once daily, was added to their therapeutic regimen. Their blood pressure was controlled by using perindopril and amlodipine, with appropriate dose adjustments when necessary. The patients were followed for a period of 3 months. Arterial stiffness was measured by means of pulse wave velocity (PWV) with the use of SphygmoCor Cardiovascular Management System (CVMS; AtCor Medical Pty Ltd, Sydney, New South Wales, Australia). Meanwhile, central arterial pressure waveforms were recorded. Concurrently, the Montreal Cognitive Assessment (MoCA) test was administered to evaluate the patients' cognitive function both at baseline and after 3 months of treatment with dapagliflozin. Baseline patient characteristics are presented in Table 1. Results At 3-month follow-up, there was a significant reduction in peripheral systolic blood pressure (pSBP) compared to baseline (129.83 vs 140.91 mmHg respectively, P < 0.001), in peripheral diastolic blood pressure (pDBP) (69.87 vs 77.58 mmHg, P < 0.001), in central systolic blood pressure (cSBP) (146.20 vs 156.25 mmHg, P < 0.001), and in central diastolic blood pressure (cDBP) (82.04 vs 89.58 mmHg, P = 0.007) (Table 2). Dapagliflozin administration also resulted in a statistically significant decrease in PWV by 1.457 (P < 0.001). Additionally, it was observed that increased values of arterial stiffness were associated with worse patient performance on the MoCA test (P = 000). After 3 months of dapagliflozin treatment, a statistically significant improvement by 1.33 was evident in the MoCA test performance (MOCA at baseline 1.54, at 3 months 1.13. (P < 0.001). Conclusion In our small cohor of patients with stage 1-4 CKD, the addition of 10 mg of dapagliflozin seems to cause reductions in both arterial stiffness and blood pressure over a period of 3-month treatment. During the same time interval, dapagliflozin seems to improve cognitive function, as evidenced by improvement in the MoCA test performance. Further studies of longer duration and of larger sample sizes are warranted in order to validate these initial promising observations.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».