Effect of dapagliflozin on non-dipper blood pressure in patients with diabetic kidney disease

Niu Di; Chen Ruifang; Pang Xinxin; Du Chaoyang; Yuan Yuan; Wang Yanan

doi:10.13406/j.cnki.cyxb.003763

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Effect of dapagliflozin on non-dipper blood pressure in patients with diabetic kidney disease

Endocrine regulation and metabolic diseases | 更新时间：2025-10-21

- Effect of dapagliflozin on non-dipper blood pressure in patients with diabetic kidney disease
- Journal of Chongqing Medical University Vol. 50, Issue 9, Pages: 1187-1194(2025)
- 作者机构：
  
  1.河南中医药大学第二临床医学院，郑州 450011
  2.河南省中医院/河南中医药大学第二附属医院肾病科，郑州 450002
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.003763
  CLC： R587
- Received：05 October 2024，
  
  Revised：2025-01-04，
  
  Accepted：13 January 2025，
  
  Published：28 September 2025
- 稿件说明：
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牛娣,陈瑞芳,庞欣欣,等.达格列净对糖尿病肾病患者非杓型血压的影响[J].重庆医科大学学报,2025,50(9):1187-1194.

Niu Di,Chen Ruifang,Pang Xinxin,et al.Effect of dapagliflozin on non-dipper blood pressure in patients with diabetic kidney disease[J].Journal of Chongqing Medical University,2025,50(9):1187-1194.
牛娣,陈瑞芳,庞欣欣,等.达格列净对糖尿病肾病患者非杓型血压的影响[J].重庆医科大学学报,2025,50(9):1187-1194. DOI： 10.13406/j.cnki.cyxb.003763.

Niu Di,Chen Ruifang,Pang Xinxin,et al.Effect of dapagliflozin on non-dipper blood pressure in patients with diabetic kidney disease[J].Journal of Chongqing Medical University,2025,50(9):1187-1194. DOI： 10.13406/j.cnki.cyxb.003763.

摘要

目的

探究达格列净对糖尿病肾病（diabetic kidney disease，DKD）患者非杓型血压的影响。

方法

选择2023年1月至2024年1月于河南省中医院肾病科住院的DKD患者104例为研究对象，分为达格列净组和对照组，每组52例。对照组给予西医常规治疗，达格列净组在对照组的基础上予达格列净（10 mg/次，1次/d），2组患者均持续治疗12周。比较2组患者治疗前后的血糖指标［空腹血糖（fasting plasma glucose，FPG）、餐后2 h血糖（2-hour postprandial blood glucose，2h PBG）、糖化血红蛋白（hemoglobin A1c，HbA1c）］、肾功能指标［血清胱抑素C（cystatin C，CysC）、尿素氮（blood urea nitrogen，BUN）、血肌酐（serum creatinine，Scr）、估算肾小球滤过率（estimated glomerular filtration rate，eGFR）、尿白蛋白/肌酐比值（urine albumin/creatinine ratio，UACR）］、24 h动态血压、非杓型血压比例和杓型血压逆转率、血电解质［血钾（potassium，K）、血钠（sodium，Na）、血氯（chloride，Cl）、血钙（calcium，Ca）、血镁（magnesium，Mg）、血磷（phosphorus，P）］、血清尿酸（serum uric acid，SUA）、尿电解质［尿钾（urine potassium，UK）、尿钠（urine sodium，UNa）、尿氯（urine chloride，UCl）、尿钙（urine calcium，UCa）、尿镁（urine magnesium，UMg）、尿磷（urine phosphorus，UP）］及不良反应发生情况。

结果

与治疗前相比，2组患者治疗后FPG、2 h PBG、HbA1c、CysC、BUN、Scr、UACR、24 h平均收缩压（24-hour systolic blood pressure，24 hSBP）、日间平均收缩压（daytime systolic blood pressure，dSBP）、夜间平均舒张压（nighttime diastolic blood pressure，nDBP）降低，eGFR升高，且达格列净组治疗后夜间平均收缩压（nighttime systolic blood pressure，nSBP）、K、SUA降低，UNa、UMg升高（

0.05）。与对照组相比，达格列净组治疗后CysC、BUN、Scr、UACR、24 hSBP、nSBP、K、SUA降低，eGFR、UNa、UMg升高（

0.05）。达格列净组治疗后非杓型血压比例低于对照组及治疗前，杓型血压逆转率高于对照组（

0.05）。治疗期间，达格列净组不良反应发生率为3.85%，对照组为5.77%，差异无统计学意义（

=1.000）。

结论

达格列净可改善DKD患者的肾功能，降低夜间血压，提高杓型血压逆转率，其促进尿钠排泄、降低血清尿酸水平可能是逆转非杓型血压的潜在机制。

Abstract

Objective

To investigate the effect of dapagliflozin on non-dipper blood pressure in patients with diabetic kidney disease （DKD）.

Methods

A total of 104 patients with DKD treated in the Department of Nephrology of Henan Provincial Hospital of Traditional Chinese Medicine from January 2023 to January 2024 were selected as the study subjects. The patients were divided into a dapagliflozin group and a control group by the random number table method，with 52 patients in each group. The control group was given conventional Western medicine treatment，and the dapagliflozin group was additionally given dapagliflozin （10 mg/dose，once a day） on the basis of the treatment in the control group. Both groups received continuous treatment for 12 weeks. The following indicators and the incidence of adverse reactions after treatment were compared between the two groups，including blood glucose indicators ［fasting plasma glucose（FPG），2-hour postprandial blood glucose （2 h PBG），and glycated hemoglobin（HbA1c）］，renal function markers［serum cystatin C（CysC），blood urea nitrogen（BUN），serum creatinine（Scr），estimated glomerular filtration rate（eGFR），and urinary albumin/creatinine ratio（UACR）］，24-h ambulatory blood pressure，proportion of non-dipper blood pressure and reversal rate of dipper blood pressure，blood electrolytes［potassium（K），sodium，chlorine，calcium，magnesium，and phosphorus］，serum uric acid（SUA），and urine electrolytes［urine potassium，urine sodium（UNa），urine chlorine，urine calcium，urine magnesium（UMg），and urine phosphorus］.

Results

The FPG，2 h PBG，HbA1c，CysC，BUN，Scr，UACR，mean 24 h systolic blood pressure（24 h SBP），mean daytime systolic blood pressure，and mean nighttime diastolic blood pressure were decreased and the eGFR was elevated in both groups after treatment. The mean nighttime systolic blood pressure（nSBP），K，and SUA were decreased and the UNa and UMg were increased in the dapagliflozin group after treatment（

0.05）. Compared with the control group，the dapagliflozin group experienced decreases in CysC，BUN，Scr，UACR，24 h SBP，nSBP，K，and SUA and increases in eGFR，UNa，and UMg after treatment（

0.05）. The proportion of non-dipper blood pressure after treatment in the dapagliflozin group was lower than that in the control group and before treatment，and the reversal rate of dipper blood pressure was higher than that in the control group（

0.05）. During treatment，the inciden

ce rates of adverse reactions was 3.85% in the dapagliflozin group and 5.77% in the control group（

=1.000）.

Conclusion

Dapagliflozin improves the renal function，decreases the nocturnal blood pressure，and increases the reversal rate of dipper blood pressure in patients with DKD. Dapagliflozin promotes UNa excretion and decreases the SUA level，which may be the potential mechanism of reversing non-dipper blood pressure.

关键词

Keywords

references

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