Abstract:
Cisplatin, a chemotherapy agent widely used since its FDA approval in 1978 for testicular cancer, is associated with nephrotoxicity and hypomagnesemia. Magnesium supplementation is not only a treatment for hypomagnesemia but also a well-established agent in preventing cisplatin-induced nephrotoxicity (CIN). Considering the challenges associated with intravenous magnesium use and even with the supplementation of oral forms, there is a need for drugs that effectively reduce urinary magnesium excretion. Amiloride and sodium-glucose cotransporter 2 inhibitors (SGLT2 inhibitors) have emerged as potential candidates. Amiloride is a well-known potassium-sparing diuretic that also has a hypomagnesemia effect seen in preclinical data. SGLT2 inhibitors are a drug class initially used in diabetes that was also observed to have positive effects on cardiovascular mortality, diabetic kidney disease, and hypomagnesemia. SGLT2 inhibitors were found to reduce hypomagnesemia in a meta-analysis study of 18 trials. However, these trials were not specifically designed for the evaluation of hypomagnesemia, and their current use in hypomagnesemia is considered off-label.
摘要:
顺铂,自1978年FDA批准用于睾丸癌以来广泛使用的化疗药物,与肾毒性和低镁血症有关。补充镁不仅是低镁血症的治疗方法,而且是预防顺铂引起的肾毒性(CIN)的公认药物。考虑到静脉使用镁,甚至补充口服形式的挑战,需要有效减少尿镁排泄的药物。阿米洛利和钠-葡萄糖协同转运蛋白2抑制剂(SGLT2抑制剂)已成为潜在的候选药物。阿米洛利是一种众所周知的保钾利尿剂,在临床前数据中也具有低镁血症作用。SGLT2抑制剂是最初用于糖尿病的一类药物,也被观察到对心血管死亡率有积极影响。糖尿病肾病,和低镁血症.在18项试验的荟萃分析研究中发现SGLT2抑制剂可降低低镁血症。然而,这些试验不是专门为评估低镁血症而设计的,它们目前在低镁血症中的使用被认为是标签外的。