慢性腎臟病(chronic kidney disease,CKD) 病因相當複雜，其中以糖尿病腎病變最為常見，治療上常藉由RAS (renin-angiotensin system) 抑制劑及相關危險因子的控制達到延緩腎功能惡化的效果。如今，隨著第二型鈉- 葡萄糖轉運通道 (sodiumglucosecotransporter 2, SGLT2) 抑制劑相關研究如雨後春筍般的發表，使臨床照護人員對於慢性腎臟病病人有更多的利器以延緩腎功能惡化；但由於研究設計及族群上的差異，醫師在處方SGLT2 抑制劑的同時，必須個人化用藥以達到不同病人的臨床需求。此篇文獻藉由回顧SGLT2 抑制劑研究的歷程、藥品相關副作用及臨床應注意事項，希望帶給臨床照護人員對於藥品有更多的認識，使慢性腎臟病病人在新興藥品SGLT2 抑制劑的使用下及臨床照護人員的細心照護下，能夠達到延緩進入透析的時間，甚至是降低病人死亡率等臨床目標。

 

The etiology of chronic kidney disease (CKD) is complex, with diabetic kidney disease being the most common cause. Treatment is often focused on delaying the deterioration of kidney function by using renin-angiotensin system inhibitors and controlling related risk factors. In recent years, studies on sodium-glucose cotransporter 2 (SGLT2) inhibitors have provided clinical caregivers with new options for delaying the deterioration of kidney function in patients with CKD. However, due to differences in research design and population, physicians must individualize the use of SGLT2 inhibitors to meet the clinical needs of different patients. This article reviews the history of SGLT2 inhibitor research, drug-related side effects, and clinical precautions. The goal is to provide clinical caregivers with a better understanding of SGLT2 inhibitors so that they can use these medications effectively to help patients with CKD achieve clinical goals such as delaying the need for dialysis and reducing patient mortality rates.

 

Submitted for publication: 2022.11.10; Accepted for publication: 2023.8.1