Abstract：
The wave of kidney and heart outcome trials, showing multiple potential benefits for sodium-glucose co-transport 2 (SGLT2) inhibitors, have excluded patients with an estimated glomerular filtration rate below 25 ml/min/1.73 m2. However, dialysis patients are at the highest risk of cardiovascular disease and would benefit most from effective cardioprotective therapies. There is emerging evidence from experimental studies and post hoc analyses of randomised clinical trials that SGLT2 inhibitors are well tolerated and may also be effective in preventing cardiovascular and mortality outcomes in patients with severe chronic kidney disease, including patients receiving dialysis. As such, extending the usage of SGLT2 inhibitors to dialysis patients could provide a major advancement in their care. Peritoneal dialysis (PD) patients have an additional unmet need for effective pharmacotherapy to preserve their residual kidney function (RKF), with its associated mortality benefits, and for treatment options that help reduce the risk of transfer to haemodialysis. Experimental data suggest that SGLT2 inhibitors, via various mechanisms, may preserve RKF and protect the peritoneal membrane. There is sound physiological rationale and an urgent clinical need to execute robust randomised control trials to study the use of SGLT2 inhibitors in PD patients to answer important questions of relevance to patients and healthcare systems.
摘要：
肾脏和心脏结局试验的浪潮，显示钠-葡萄糖共转运2（SGLT2）抑制剂的多种潜在益处，排除了估计肾小球滤过率低于25ml/min/1.73m2的患者。然而,透析患者患心血管疾病的风险最高,从有效的心脏保护疗法中获益最大.来自随机临床试验的实验研究和事后分析的新证据表明，SGLT2抑制剂具有良好的耐受性，并且还可以有效预防严重慢性肾脏疾病患者的心血管疾病和死亡结局。包括接受透析的病人.因此，将SGLT2抑制剂的使用范围扩大到透析患者可以为他们的护理带来重大进步.腹膜透析（PD）患者对有效的药物治疗有额外的未满足的需求，以保持他们的残余肾功能（RKF），与其相关的死亡率益处，以及有助于降低转移到血液透析的风险的治疗方案。实验数据表明，SGLT2抑制剂，通过各种机制，可以保存RKF并保护腹膜。有合理的生理理论基础和迫切的临床需要执行强有力的随机对照试验来研究SGLT2抑制剂在PD患者中的使用，以回答与患者和医疗保健系统相关的重要问题。
