PDF(Pubmed)
Abstract：
UNASSIGNED: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are recommended by Kidney Disease: Improving Global Outcomes (KDIGO) as risk-based treatment for hyperglycemia, weight management, and cardiovascular (CV) risk reduction in people with type 2 diabetes (T2D) and chronic kidney disease (CKD). The aim of this post hoc analysis was to assess treatment effects of once weekly semaglutide on kidney disease outcomes by KDIGO risk category and on changes in KDIGO risk category, compared with placebo.
UNASSIGNED: Participants with T2D and established CV disease or at high CV risk treated with once weekly semaglutide or placebo in SUSTAIN 6 (NCT01720446) were stratified by baseline KDIGO risk category (low [n = 1596], moderate [n = 831], high [n = 445], very high [n = 366]). Treatment effect was analyzed for a kidney disease composite end point (macroalbuminuria, serum creatinine doubling and estimated glomerular filtration rate [eGFR] < 45 ml/min per 1.73 m2, kidney replacement therapy, or death due to kidney disease) from baseline to 2 years.
UNASSIGNED: The treatment effect of semaglutide versus placebo was consistent across KDIGO categories for the kidney disease composite end point (hazard ratio [95% confidence interval (CI)]: 0.35 [0.07-1.72], 0.42 [0.25-0.72], 0.87 [0.45-1.71], and 0.72 [0.42-1.23] for low, moderate, high, and very high risk categories, respectively; P interaction = 0.28). Participants receiving semaglutide were more likely to move to a lower KDIGO risk category (odds ratio: 1.69; 95% CI: [1.32-2.16]) and less likely to move to a higher KDIGO risk category versus placebo (odds ratio: 0.71; 95% CI: [0.59-0.86]).
UNASSIGNED: Once weekly semaglutide versus placebo reduced risks of kidney disease end points and improved risk categories irrespective of baseline KDIGO risk.
UNASSIGNED: Participants with T2D and established CV disease or at high CV risk treated with once weekly semaglutide or placebo in SUSTAIN 6 (NCT01720446) were stratified by baseline KDIGO risk category (low [n = 1596], moderate [n = 831], high [n = 445], very high [n = 366]). Treatment effect was analyzed for a kidney disease composite end point (macroalbuminuria, serum creatinine doubling and estimated glomerular filtration rate [eGFR] < 45 ml/min per 1.73 m2, kidney replacement therapy, or death due to kidney disease) from baseline to 2 years.
UNASSIGNED: The treatment effect of semaglutide versus placebo was consistent across KDIGO categories for the kidney disease composite end point (hazard ratio [95% confidence interval (CI)]: 0.35 [0.07-1.72], 0.42 [0.25-0.72], 0.87 [0.45-1.71], and 0.72 [0.42-1.23] for low, moderate, high, and very high risk categories, respectively; P interaction = 0.28). Participants receiving semaglutide were more likely to move to a lower KDIGO risk category (odds ratio: 1.69; 95% CI: [1.32-2.16]) and less likely to move to a higher KDIGO risk category versus placebo (odds ratio: 0.71; 95% CI: [0.59-0.86]).
UNASSIGNED: Once weekly semaglutide versus placebo reduced risks of kidney disease end points and improved risk categories irrespective of baseline KDIGO risk.
摘要：
■胰高血糖素样肽-1受体激动剂（GLP-1RAs）被肾脏疾病推荐：改善全球结果（KDIGO）作为高血糖症的基于风险的治疗，体重管理,2型糖尿病（T2D）和慢性肾脏疾病（CKD）患者的心血管（CV）风险降低。本事后分析的目的是按KDIGO风险类别和KDIGO风险类别的变化评估每周一次的司美鲁肽对肾脏疾病结局的治疗效果。与安慰剂相比。
■在SUSTAIN6（NCT01720446）中接受每周一次司马鲁肽或安慰剂治疗的T2D和已确定的CV疾病或高CV风险的参与者按基线KDIGO风险类别（低[n=1596]，中等[n=831]，高[n=445]，非常高[n=366])。分析肾脏疾病复合终点的治疗效果(大量白蛋白尿，血清肌酐倍增和估计肾小球滤过率[eGFR]<45毫升/分钟每1.73平方米，肾脏替代治疗，或因肾脏疾病而死亡）从基线到2年。
■对于肾脏疾病复合终点，司马鲁肽与安慰剂的治疗效果在KDIGO类别中一致（风险比[95％置信区间（CI）]：0.35[0.07-1.72]，0.42[0.25-0.72],0.87[0.45-1.71],和0.72[0.42-1.23]为低点，中度,高,和非常高风险的类别，分别为；P交互作用=0.28)。与安慰剂相比，接受semaglutide的参与者更有可能移至较低的KDIGO风险类别（比值比：1.69;95％CI：[1.32-2.16]），并且不太可能移至较高的KDIGO风险类别（比值比：0.71;95％CI：[0.59-0.86]）。
与安慰剂相比，每周一次的司美鲁肽可降低肾脏疾病终点的风险，并改善风险类别，而与基线KDIGO风险无关。
■在SUSTAIN6（NCT01720446）中接受每周一次司马鲁肽或安慰剂治疗的T2D和已确定的CV疾病或高CV风险的参与者按基线KDIGO风险类别（低[n=1596]，中等[n=831]，高[n=445]，非常高[n=366])。分析肾脏疾病复合终点的治疗效果(大量白蛋白尿，血清肌酐倍增和估计肾小球滤过率[eGFR]<45毫升/分钟每1.73平方米，肾脏替代治疗，或因肾脏疾病而死亡）从基线到2年。
■对于肾脏疾病复合终点，司马鲁肽与安慰剂的治疗效果在KDIGO类别中一致（风险比[95％置信区间（CI）]：0.35[0.07-1.72]，0.42[0.25-0.72],0.87[0.45-1.71],和0.72[0.42-1.23]为低点，中度,高,和非常高风险的类别，分别为；P交互作用=0.28)。与安慰剂相比，接受semaglutide的参与者更有可能移至较低的KDIGO风险类别（比值比：1.69;95％CI：[1.32-2.16]），并且不太可能移至较高的KDIGO风险类别（比值比：0.71;95％CI：[0.59-0.86]）。
与安慰剂相比，每周一次的司美鲁肽可降低肾脏疾病终点的风险，并改善风险类别，而与基线KDIGO风险无关。
