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Caravaca-Fontán F, Stevens K, Padrón M, Huerta A, Montomoli M, Villa J, González F, Vega C, López Mendoza M, Fernández L, Shabaka A, Rodríguez-Moreno A, Martín-Gómez A, Labrador PJ, Molina Andújar A, Prados Soler MC, Martín-Penagos L, Yerovi E, Medina Zahonero L, De La Flor JC, Mon C, Ibernon M, Rodríguez Gómez A, Miquel R, Sierra M, Mascarós V, Luzardo L, Papasotiriou M, Arroyo D, Verdalles Ú, Martínez-Miguel P, Ramírez-Guerrero G, Pampa-Saico S, Moral Berrio E, Canga JLP, Tarragón B, Fraile Gómez P, Regidor D, Relea J, Xipell M, Andrades Gómez C, Navarro M, Álvarez Á, Rivas B, Quintana LF, Gutiérrez E, Pérez-Valdivia MÁ, Odler B, Kronbichler A, Geddes C, Anders HJ, Floege J, Fernández-Juárez G, Praga M. Sodium-glucose cotransporter 2 inhibition in primary and secondary glomerulonephritis. Nephrol Dial Transplant 2024; 39:328-340. [PMID: 37550217 DOI: 10.1093/ndt/gfad175] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND The role of sodium-glucose cotransporter 2 inhibitors (SGLT2i) in the management glomerular/systemic autoimmune diseases with proteinuria in real-world clinical settings is unclear. METHODS This is a retrospective, observational, international cohort study. Adult patients with biopsy-proven glomerular diseases were included. The main outcome was the percentage reduction in 24-h proteinuria from SGLT2i initiation to 3, 6, 9 and 12 months. Secondary outcomes included percentage change in estimated glomerular filtration rate (eGFR), proteinuria reduction by type of disease and reduction of proteinuria ≥30% from SGLT2i initiation. RESULTS Four-hundred and ninety-three patients with a median age of 55 years and background therapy with renin-angiotensin system blockers were included. Proteinuria from baseline changed by -35%, -41%, -45% and -48% at 3, 6, 9 and 12 months after SGLT2i initiation, while eGFR changed by -6%, -3%, -8% and -10.5% at 3, 6, 9 and 12 months, respectively. Results were similar irrespective of the underlying disease. A correlation was found between body mass index (BMI) and percentage proteinuria reduction at last follow-up. By mixed-effects logistic regression model, serum albumin at SGLT2i initiation emerged as a predictor of ≥30% proteinuria reduction (odds ratio for albumin <3.5 g/dL, 0.53; 95% CI 0.30-0.91; P = .02). A slower eGFR decline was observed in patients achieving a ≥30% proteinuria reduction: -3.7 versus -5.3 mL/min/1.73 m2/year (P = .001). The overall tolerance to SGLT2i was good. CONCLUSIONS The use of SGLT2i was associated with a significant reduction of proteinuria. This percentage change is greater in patients with higher BMI. Higher serum albumin at SGLT2i onset is associated with higher probability of achieving a ≥30% proteinuria reduction.
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Affiliation(s)
| | - Kate Stevens
- Department of Nephrology and Transplantation, Queen Elizabeth University Hospital, Glasgow, UK
| | - Maite Padrón
- Department of Nephrology, Complejo Hospitalario de Toledo, Toledo, Spain
| | - Ana Huerta
- Department of Nephrology, Hospital Universitario Puerta de Hierro, Madrid, Spain
| | - Marco Montomoli
- Department of Nephrology, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Juan Villa
- Department of Nephrology, Hospital Universitario de Badajoz, Badajoz, Spain
| | - Fayna González
- Department of Nephrology, Hospital Doctor Negrín, Gran Canaria, Spain
| | - Cristina Vega
- Department of Nephrology, Hospital Universitario La Paz, Madrid, Spain
| | - Manuel López Mendoza
- Department of Nephrology, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Loreto Fernández
- Department of Nephrology, Complejo Hospitalario de Navarra, Navarra, Spain
| | - Amir Shabaka
- Department of Nephrology, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | | | | | - Pedro J Labrador
- Department of Nephrology, Hospital San Pedro de Alcántara, Cáceres, Spain
| | | | | | - Luis Martín-Penagos
- Department of Nephrology, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Estefanía Yerovi
- Department of Nephrology, Hospital Universitario de Burgos, Burgos, Spain
| | | | | | - Carmen Mon
- Department of Nephrology, Hospital Universitario Severo Ochoa, Leganés, Madrid, Spain
| | - Meritxell Ibernon
- Department of Nephrology, Hospital Sant Joan Despí Moisès Broggi, Barcelona, Spain
| | | | - Rosa Miquel
- Department of Nephrology, Hospital Universitario Canarias, Tenerife, Spain
| | - Milagros Sierra
- Department of Nephrology, Hospital San Pedro de Logroño, La Rioja, Logroño, Spain
| | - Victoria Mascarós
- Department of Nephrology, Hospital Francesc de Borja, Gandia, Valencia, Spain
| | - Leonella Luzardo
- Department of Nephrology, Hospital de Clínicas "Dr Manuel Quintela", Universidad de la República, Montevideo, Uruguay
| | | | - David Arroyo
- Department of Nephrology, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - Úrsula Verdalles
- Department of Nephrology, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | | | | | - Saúl Pampa-Saico
- Department of Nephrology, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain
| | - Esperanza Moral Berrio
- Department of Nephrology, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | - José Luis Pérez Canga
- Department of Nephrology, Hospital Universitario San Agustín, Avilés, Asturias, Spain
| | - Blanca Tarragón
- Department of Nephrology, Hospital Universitario de Getafe, Getafe, Madrid, Spain
| | - Pilar Fraile Gómez
- Department of Nephrology, Hospital Universitario de Salamanca, Salamanca, Spain
| | - Dabaiba Regidor
- Department of Nephrology, Complejo Hospitalario de Toledo, Toledo, Spain
| | - Javier Relea
- Department of Nephrology, Hospital Universitario Puerta de Hierro, Madrid, Spain
| | - Marc Xipell
- Department of Nephrology, Hospital Clinic, Barcelona, Spain
| | | | - Maruja Navarro
- Department of Nephrology, Hospital Sant Joan Despí Moisès Broggi, Barcelona, Spain
| | - Álvaro Álvarez
- Department of Nephrology, Hospital Universitario de Badajoz, Badajoz, Spain
| | - Begoña Rivas
- Department of Nephrology, Hospital Universitario La Paz, Madrid, Spain
| | | | - Eduardo Gutiérrez
- Department of Nephrology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | - Balazs Odler
- Department of Medicine, University of Cambridge, Cambridge, UK
- Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Andreas Kronbichler
- Department of Medicine, University of Cambridge, Cambridge, UK
- Department of Internal Medicine IV, Nephrology and Hypertension, Medical University Innsbruck, Innsbruck, Austria
| | - Colin Geddes
- Department of Nephrology and Transplantation, Queen Elizabeth University Hospital, Glasgow, UK
| | - Hans-Joachim Anders
- Department of Internal Medicine IV, Hospital of the Ludwig Maximilians University, Munich, Germany
| | - Jürgen Floege
- Division of Nephrology, RWTH Aachen University Hospital, Aachen, Germany
| | | | - Manuel Praga
- Instituto de Investigación Hospital 12 de Octubre (imas12), Madrid, Spain
- Department of Nephrology, Hospital Universitario 12 de Octubre, Madrid, Spain
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Cintra M, Pedraza Cezón LA, Martín Navarro JA, Torres Aguilera E, Albalate Ramón M, Alcázar Arroyo R, Procaccini F, Puerta Carretero M, Ortega Díaz M, Medina Zahonero L, Jaldo Rodríguez MT, de Sequera P. Acute renal failure due to rhabdomyolysis in relation to abiraterone and rosuvastatin. Nefrologia 2023; 43:374-376. [PMID: 37500306 DOI: 10.1016/j.nefroe.2021.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 04/06/2021] [Indexed: 07/29/2023] Open
Affiliation(s)
- Melissa Cintra
- Servicio de Nefrología, Hospital Infanta Leonor, Madrid, Spain.
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Martín Navarro JA, Cintra Cabrera M, Proccacini F, Muñoz Rodríguez J, Roldán Cortés D, Lucena Valverde R, Ortega Díaz M, Puerta Carretero M, Gil Herrera J, Jaldo Rodríguez MT, Albalate Ramón M, Corchete Prats E, Medina Zahonero L, de Sequera Ortiz P, Alcázar Arroyo R. More difficult still: Treating severe rapidly progressive glomerulonephritis in the context of COVID-19 pneumonia. Nefrologia 2022; 42:94-98. [PMID: 36153904 PMCID: PMC8851205 DOI: 10.1016/j.nefroe.2020.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 12/21/2020] [Accepted: 12/22/2020] [Indexed: 06/16/2023] Open
Abstract
We present the case of a male patient with severe SARS-CoV-2 pneumonia, with simultaneous onset of p-ANCA positive rapidly progressive glomerulonephritis. We discuss the different therapeutic possibilities, emphasising the appropriateness of their administration according to the time in the course of the infection.
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Affiliation(s)
| | | | - Fabio Proccacini
- Servicio de Nefrología, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - Jorge Muñoz Rodríguez
- Servicio de Anatomía Patológica, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - David Roldán Cortés
- Servicio de Anatomía Patológica, Hospital Universitario Infanta Leonor, Madrid, Spain
| | | | - Mayra Ortega Díaz
- Servicio de Nefrología, Hospital Universitario Infanta Leonor, Madrid, Spain
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Cintra M, Pedraza Cezón LA, Martín Navarro JA, Torres Aguilera E, Albalate Ramón M, Alcázar Arroyo R, Procaccini F, Puerta Carretero M, Ortega Díaz M, Medina Zahonero L, Jaldo Rodríguez MT, de Sequera P. Acute renal failure due to rhabdomyolysis in relation to abiraterone and rosuvastatin. Nefrologia 2021; 43:S0211-6995(21)00165-X. [PMID: 34503863 DOI: 10.1016/j.nefro.2021.04.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 04/06/2021] [Indexed: 11/21/2022] Open
Affiliation(s)
- Melissa Cintra
- Servicio de Nefrología, Hospital Infanta Leonor, Madrid, España.
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Martín Navarro JA, Cintra Cabrera M, Lucca Proccacini F, Muñoz Rodríguez J, Roldán Cortés D, Lucena Valverde R, Ortega Díaz M, Puerta Carretero M, Gil Herrera J, Jaldo Rodríguez MT, Albalate Ramón M, Corchete Prats E, Medina Zahonero L, de Sequera Ortiz P, Alcázar Arroyo R. More difficult still: Treating severe rapidly progressive glomerulonephritis in the context of COVID-19 pneumonia. Nefrologia 2021; 42:S0211-6995(21)00012-6. [PMID: 33781578 PMCID: PMC7843118 DOI: 10.1016/j.nefro.2020.12.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 12/21/2020] [Accepted: 12/22/2020] [Indexed: 12/12/2022] Open
Abstract
We present the case of a male patient with severe SARS-CoV-2 pneumonia, with simultaneous onset of p-ANCA positive rapidly progressive glomerulonephritis. We discuss the different therapeutic possibilities, emphasising the appropriateness of their administration according to the time in the course of the infection.
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Affiliation(s)
| | | | | | - Jorge Muñoz Rodríguez
- Servicio de Anatomía Patológica, Hospital Universitario Infanta Leonor, Madrid, España
| | - David Roldán Cortés
- Servicio de Anatomía Patológica, Hospital Universitario Infanta Leonor, Madrid, España
| | | | - Mayra Ortega Díaz
- Servicio de Nefrología, Hospital Universitario Infanta Leonor, Madrid, España
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Puerta Carretero M, Ortega Díaz M, Corchete Prats E, Roldán Cortés D, Cuevas Tascón G, Martín Navarro JA, Jaldo Rodríguez MT, Medina Zahonero L, Cintra Cabrera M, Ryan Murúa P, Albalate Ramón M, de Sequera Ortiz P, Alcázar Arroyo R. Necrotizing glomerulonephritis in patients with HIV, HCV and visceral leishmaniasis. Nefrologia 2019; 40:481-484. [PMID: 31551119 DOI: 10.1016/j.nefro.2019.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 05/25/2019] [Indexed: 11/17/2022] Open
Affiliation(s)
| | - Mayra Ortega Díaz
- Servicio de Nefrología, Hospital Universitario Infanta Leonor, Madrid, España
| | | | - David Roldán Cortés
- Servicio de Anatomía Patológica, Hospital Universitario Infanta Leonor, Madrid, España
| | | | | | | | | | | | - Pablo Ryan Murúa
- Servicio de Anatomía Patológica, Hospital Universitario Infanta Leonor, Madrid, España
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