BMJ《SGLT-2 抑制剂用于成人慢性肾脏病患者临床实践指南》解读
Interpretation of BMJ Clinical Practice Guideline: SGLT-2 Inhibitors for Adults with Chronic Kidney Disease
瞿芙容 1赵黎君 1曾筱茜 2李静 3李舍予4
作者信息
- 1. 610041 四川省成都市，四川大学华西医院全科医学科
- 2. 610041 四川省成都市，四川大学华西医院肾内科
- 3. 610041 四川省成都市，四川大学华西医院内分泌代谢科
- 4. 610041 四川省成都市，四川大学华西医院循证医学中心循证评价与快速指南研究室 中国 Cochrane 中心 中国 MAGIC 中心;610041 四川省成都市，四川大学华西医院内分泌代谢科
- 折叠
摘要
2024年10月在BMJ期刊发布的《SGLT-2抑制剂用于成人慢性肾脏疾病患者临床实践指南》基于估算肾小球滤过率（eGFR）与蛋白尿水平对慢性肾脏疾病（CKD）患者的并发症和进展风险进行分层，将其划分为低危、中危、高危和极高危4个层级。指南对不同风险层级患者使用钠-葡萄糖共转运蛋白2（SGLT-2）抑制剂的获益与风险进行了量化评估，提出了分层推荐策略，例如，对于CKD进展及并发症风险较低或中等的成年患者，可以考虑使用SGLT-2抑制剂（弱推荐）；而对于风险较高或极高的成年患者，则推荐使用SGLT-2抑制剂（强推荐）。为患者的个体化决策提供了依据，有助于全科医生在不同临床场景中合理规范使用SGLT-2抑制剂。此外，指南快速推荐的网页版提供了高度可视化的证据和推荐呈现工具，便于全科医生快速查询，并支持医患共同决策的实施。
Abstract
The clinical practice guideline on the use of sodium-glucose cotransporter 2 (SGLT-2) inhibitors in adult patients with chronic kidney disease (CKD), published in the BMJ in October 2024, stratifies patients with CKD into four risk tierslow, moderate, high, and very highbased on estimated glomerular filtration rate (eGFR) and proteinuria levels to assess their risk of complications and disease progression. The guideline provides a quantitative evaluation of the benefits and risks of SGLT-2 inhibitors across different risk tiers and proposes a tiered recommendation strategy. For instance, for adult patients with CKD who have a low or moderate risk of disease progression and complications, the use of SGLT-2 inhibitors can be considered (weak recommendation); whereas for those with a high or very high risk, the use of SGLT-2 inhibitors is recommended (strong recommendation). This approach supports individualized decision-making for patients and assists general practitioners in the rational and standardized use of SGLT-2 inhibitors across diverse clinical settings. Additionally, the guideline's rapid-access web version offers highly visualized evidence and recommendation presentation tools, facilitating quick reference for general practitioners and supporting the implementation of shared decision-making between clinicians and patients.关键词
钠 - 葡萄糖共转运蛋白 2 抑制剂/慢性肾脏疾病/风险分级/诊疗指南/医患共同决策引用本文复制引用
瞿芙容,赵黎君,曾筱茜,李静,李舍予.BMJ《SGLT-2 抑制剂用于成人慢性肾脏病患者临床实践指南》解读[EB/OL].(2026-03-23)[2026-03-26].https://chinaxiv.org/abs/202603.00121.学科分类
临床医学/内科学
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