{"id":254378,"date":"2025-01-21T13:18:21","date_gmt":"2025-01-21T12:18:21","guid":{"rendered":"https:\/\/r3i.org\/%e3%83%a9%e3%83%b3%e3%83%89%e3%83%9e%e3%83%bc%e3%82%af-empa-kidney%e8%a9%a6%e9%a8%93\/"},"modified":"2025-02-16T22:33:33","modified_gmt":"2025-02-16T21:33:33","slug":"%e3%83%a9%e3%83%b3%e3%83%89%e3%83%9e%e3%83%bc%e3%82%af-empa-kidney%e8%a9%a6%e9%a8%93","status":"publish","type":"page","link":"https:\/\/r3i.org\/ja\/%e3%83%a9%e3%83%b3%e3%83%89%e3%83%9e%e3%83%bc%e3%82%af-empa-kidney%e8%a9%a6%e9%a8%93\/","title":{"rendered":"\u30e9\u30f3\u30c9\u30de\u30fc\u30af – EMPA-KIDNEY\u8a66\u9a13"},"content":{"rendered":"

[et_pb_section fb_built=”1″ _builder_version=”4.27.4″ _module_preset=”default” custom_padding=”1px|||||” global_colors_info=”{}”][et_pb_row _builder_version=”4.27.4″ _module_preset=”default” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.27.4″ _module_preset=”default” global_colors_info=”{}”][et_pb_text _builder_version=”4.27.4″ _module_preset=”default” header_2_text_color=”gcid-primary-color” header_5_text_color=”gcid-secondary-color” text_orientation=”center” width=”99%” custom_margin=”|-147px||||” custom_padding=”|0px||||” global_colors_info=”{%22gcid-primary-color%22:%91%22quote_text_color%22,%22quote_text_color%22,%22quote_text_color%22,%22header_2_text_color%22%93,%22gcid-secondary-color%22:%91%22header_5_text_color%22%93}”]<\/p>\n

EMPA-KIDNEY\u8a66\u9a13\uff08\u30a8\u30f3\u30d1\u30b0\u30ea\u30d5\u30ed\u30b8\u30f3\u306b\u3088\u308b\u5fc3\u81d3\u30fb\u814e\u81d3\u4fdd\u8b77\u8a66\u9a13\uff09\uff1a\u30a8\u30f3\u30d1\u30b0\u30ea\u30d5\u30ed\u30b8\u30f3\u304c\u6162\u6027\u814e\u81d3\u75c5\u60a3\u8005\u306b\u304a\u3044\u3066\u814e\u81d3\u304a\u3088\u3073\u5fc3\u8840\u7ba1\u306b\u6709\u7528\u6027\u3092\u793a\u3059<\/span><\/h2>\n
13 2023\u5e744\u6708<\/span><\/h5>\n
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\u75be\u60a3\u9032\u884c\u30ea\u30b9\u30af\u306e\u3042\u308b\u6162\u6027\u814e\u81d3\u75c5\uff08CKD\uff09\u60a3\u8005\u306b\u304a\u3044\u3066\u3001\u30a8\u30f3\u30d1\u30b0\u30ea\u30d5\u30ed\u30b8\u30f3\u306e\u6295\u4e0e\u306f\u3001\u30d7\u30e9\u30bb\u30dc\u3068\u6bd4\u8f03\u3057\u3066\u3001\u814e\u81d3\u75c5\u306e\u9032\u884c\u307e\u305f\u306f\u5fc3\u8840\u7ba1\u7cfb\u306e\u539f\u56e0\u306b\u3088\u308b\u6b7b\u4ea1\u306e\u30ea\u30b9\u30af\u306e\u4f4e\u4e0b\u3068\u95a2\u9023\u3057\u3066\u3044\u305f\u3002<\/div>\n
EMPA-KIDNEY Collaborative Group; Herrington WG, Staplin N, Wanner C, et al. \u6162\u6027\u814e\u81d3\u75c5\u60a3\u8005\u306b\u304a\u3051\u308b\u30a8\u30f3\u30d1\u30b0\u30ea\u30d5\u30ed\u30b8\u30f3\u3002N Engl J Med 2022; doi: 10.1056\/NEJMoa2204233. <\/em><\/div>\n<\/div>\n<\/div>\n
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\n\n\n\n\n\n\n\n\n
\u7814\u7a76\u6982\u8981<\/strong><\/td>\n<\/tr>\n
\u76ee\u7684<\/strong><\/td>\nCKD\u60a3\u8005\u306b\u304a\u3044\u3066\u3001\u30a8\u30f3\u30d1\u30b0\u30ea\u30d5\u30ed\u30b8\u30f3\u306e1\u65e51\u56de\u6295\u4e0e\u304c\u814e\u75be\u60a3\u304a\u3088\u3073\u5fc3\u8840\u7ba1\u75be\u60a3\u306e\u9032\u884c\u306b\u53ca\u307c\u3059\u5f71\u97ff\u3092\u691c\u8a0e\u3059\u308b\u3053\u3068<\/td>\n<\/tr>\n
\u8a66\u9a13\u30c7\u30b6\u30a4\u30f3<\/strong><\/td>\nEMPA-KIDNEY\u306f\u56fd\u969b\u5171\u540c\u7121\u4f5c\u70ba\u5316\u4e26\u884c\u7fa4\u9593\u4e8c\u91cd\u76f2\u691c\u30d7\u30e9\u30bb\u30dc\u5bfe\u7167\u81e8\u5e8a\u8a66\u9a13\u3067\u3042\u308b\u3002<\/td>\n<\/tr>\n
\u7814\u7a76\u5bfe\u8c61\u8005<\/strong><\/td>\n\u30a2\u30eb\u30d6\u30df\u30f3\u5c3f\u306e\u7a0b\u5ea6\u306b\u304b\u304b\u308f\u3089\u305a\u3001\u4eba\u7a2e\u8abf\u6574\u63a8\u5b9a\u7cf8\u7403\u4f53\u6ffe\u904e\u91cf\uff08eGFR\u3001Chronic Kidney Disease Epidemiology Collaboration\u306e\u8a08\u7b97\u5f0f\u3092\u7528\u3044\u3066\u7b97\u51fa\uff09\u304c20\u4ee5\u4e0a\u3001<45 mL\/\u5206\/1.73 m2\u306e\u6210\u4eba\uff08\u7cd6\u5c3f\u75c5\u306e\u6709\u7121\u306f\u554f\u308f\u306a\u3044\uff09\u3001\u307e\u305f\u306f\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u6642\u306b\u5c3f\u4e2d\u30a2\u30eb\u30d6\u30df\u30f3\/\u30af\u30ec\u30a2\u30c1\u30cb\u30f3\u6bd4\u304c200\u4ee5\u4e0a\u3067eGFR\u304c45\u4ee5\u4e0a\u3001<90 mL\/\u5206\/1.73 m2\u306e\u6210\u4eba\u3002\u60a3\u8005\u306f\u81e8\u5e8a\u7684\u306b\u9069\u5207\u306a\u7528\u91cf\u306e\u30ec\u30cb\u30f3\u30fb\u30a2\u30f3\u30b8\u30aa\u30c6\u30f3\u30b7\u30f3\u7cfb\uff08RAS\uff09\u963b\u5bb3\u85ac\u306e\u5358\u5264\u6295\u4e0e\u3092\u53d7\u3051\u3066\u3044\u308b\u3053\u3068\u304c\u5fc5\u8981\u3067\u3042\u3063\u305f\u304c\u3001\u6cbb\u9a13\u8cac\u4efb\u533b\u5e2b\u304cRAS\u963b\u5bb3\u85ac\u306e\u9069\u5fdc\u304c\u306a\u3044\u3001\u3042\u308b\u3044\u306f\u5fcd\u5bb9\u6027\u304c\u306a\u3044\u3068\u5224\u65ad\u3057\u305f\u5834\u5408\u306f\u7d44\u307f\u5165\u308c\u308b\u3053\u3068\u304c\u3067\u304d\u305f\u3002\u4e3b\u306a\u9664\u5916\u57fa\u6e96\u306f\u591a\u767a\u6027\u56a2\u80de\u814e\u307e\u305f\u306f\u814e\u79fb\u690d\u3067\u3042\u3063\u305f\u3002 <\/td>\n<\/tr>\n
\u4e3b\u306a\u7814\u7a76\u5909\u6570<\/strong><\/td>\n– \u4e3b\u8981\u30a2\u30a6\u30c8\u30ab\u30e0\uff1a\u814e\u81d3\u75c5\u306e\u9032\u884c\u307e\u305f\u306f\u5fc3\u8840\u7ba1\u7cfb\u306e\u539f\u56e0\u306b\u3088\u308b\u6b7b\u4ea1\u306e\u6700\u521d\u306e\u767a\u751f\u3002\u814e\u81d3\u75c5\u306e\u9032\u884c\u306f\u3001\u672b\u671f\u814e\u81d3\u75c5\uff08\u7dad\u6301\u900f\u6790\u306e\u958b\u59cb\u307e\u305f\u306f\u814e\u79fb\u690d\u306e\u53d7\u5165\uff09\u3001eGFR\u306e\u6301\u7d9a\u7684\u4f4e\u4e0b\uff0810mL\/\u5206\/1.73m2\u672a\u6e80\uff09\u3001eGFR\u306e\u30d9\u30fc\u30b9\u30e9\u30a4\u30f3\u304b\u3089\u306e\u6301\u7d9a\u7684\u4f4e\u4e0b\u226740\uff05\u3001\u307e\u305f\u306f\u814e\u81d3\u306e\u539f\u56e0\u306b\u3088\u308b\u6b7b\u4ea1\u3068\u5b9a\u7fa9\u3057\u305f\u3002
– \u4e8b\u524d\u306b\u898f\u5b9a\u3055\u308c\u305f\u4e3b\u8981\u306a\u526f\u6b21\u7684\u30a2\u30a6\u30c8\u30ab\u30e0\uff1a\u5fc3\u4e0d\u5168\u306b\u3088\u308b\u5165\u9662\u307e\u305f\u306f\u5fc3\u8840\u7ba1\u7cfb\u306e\u539f\u56e0\u306b\u3088\u308b\u6b7b\u4ea1\u3001\u3042\u3089\u3086\u308b\u539f\u56e0\u306b\u3088\u308b\u5165\u9662\u3001\u3042\u3089\u3086\u308b\u539f\u56e0\u306b\u3088\u308b\u6b7b\u4ea1\u306e\u8907\u5408\u3002<\/td>\n<\/tr>\n
\u65b9\u6cd5<\/strong><\/td>\n\u5c11\u306a\u304f\u3068\u30826\u9031\u9593\u306e\u30e9\u30f3\u30a4\u30f3\u30d5\u30a7\u30fc\u30ba\uff08\u30d7\u30e9\u30bb\u30dc\uff09\u3092\u5b8c\u4e86\u3057\u305f\u9069\u683c\u60a3\u8005\u306f\u3001\u30a8\u30f3\u30d1\u30b0\u30ea\u30d5\u30ed\u30b8\u30f3\uff081\u65e51\u56de10mg\uff09\u307e\u305f\u306f\u30de\u30c3\u30c1\u3059\u308b\u30d7\u30e9\u30bb\u30dc\u306b\u3088\u308b\u6cbb\u7642\u306b\u7121\u4f5c\u70ba\u306b\u5272\u308a\u4ed8\u3051\u3089\u308c\u305f\u3002\u60a3\u8005\u306f\u8ffd\u8de1\u8abf\u67fb\u6642\u306b\u814e\u81d3\u306e\u72b6\u614b\uff08\u900f\u6790\u6cbb\u7642\u307e\u305f\u306f\u814e\u79fb\u690d\u306e\u53d7\u5165\uff09\u3001\u5272\u308a\u4ed8\u3051\u3089\u308c\u305f\u8a66\u9a13\u30ec\u30b8\u30e1\u30f3\u306e\u9075\u5b88\u3001\u4f75\u7528\u85ac\u3001\u30d0\u30a4\u30bf\u30eb\u30b5\u30a4\u30f3\u3001\u81e8\u5e8a\u691c\u67fb\u306e\u5b89\u5168\u6027\u304a\u3088\u3073\u6709\u5bb3\u4e8b\u8c61\u306b\u3064\u3044\u3066\u8a55\u4fa1\u3055\u308c\u305f\u3002 <\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n
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\u7d50\u679c<\/strong><\/div>\n
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\u30e9\u30f3\u30a4\u30f3\u30d5\u30a7\u30fc\u30ba\u306b\u767b\u9332\u3055\u308c\u305f8184\u4f8b\u306e\u3046\u3061\u30016609\u4f8b\u304c\u30a8\u30f3\u30d1\u30b0\u30ea\u30d5\u30ed\u30b8\u30f3\u7fa4\uff08n=3304\uff09\u3068\u30d7\u30e9\u30bb\u30dc\u7fa4\uff08n=3305\uff09\u306b\u7121\u4f5c\u70ba\u306b\u5272\u308a\u4ed8\u3051\u3089\u308c\u305f\u3002\u4e21\u7fa4\u306f\u30d9\u30fc\u30b9\u30e9\u30a4\u30f3\u306e\u7279\u5fb4\uff08\u5e73\u5747\u5e74\u9f6263.8\u6b73\u3001\u5973\u602733\uff05\u3001\u7cd6\u5c3f\u75c546\uff05\uff09\u304c\u985e\u4f3c\u3057\u3066\u304a\u308a\u3001\u75be\u60a3\u9032\u884c\u30ea\u30b9\u30af\u306e\u3042\u308bCKD\u60a3\u8005\u3092\u5e83\u304f\u4ee3\u8868\u3057\u3066\u3044\u305f\u3002\u5168\u4f53\u306e3\u5206\u306e1\u4ee5\u4e0a\uff0834.5\uff05\uff09\u306feGFR<30 mL\/min\/ 1.73m<\/sup>2\u3067\u3042\u3063\u305f\u3002 <\/p>\n

 <\/p>\n

\u672c\u8a66\u9a13\u306f\u3001\u4e8b\u524d\u306b\u898f\u5b9a\u3055\u308c\u305f\u30eb\u30fc\u30eb\uff08\u4e0a\u8a18\u53c2\u7167\uff09\u306e\u9054\u6210\u306b\u57fa\u3065\u304d2022\u5e743\u67087\u65e5\u306b\u4e2d\u6b62\u3055\u308c\u3001\u8ffd\u8de1\u8abf\u67fb\u306f7\u67085\u65e5\u306b\u7d42\u4e86\u3057\u305f\u3002\u5168\u4f53\u306e\u5e73\u5747\u6cbb\u7642\u671f\u9593\u306f2.0\u5e74\uff08\u56db\u5206\u4f4d\u7bc4\u56f2\u30011.5\uff5e2.4\u5e74\uff09\u3067\u3042\u3063\u305f\u3002 <\/p>\n

 <\/p>\n

\u30a8\u30f3\u30d1\u30b0\u30ea\u30d5\u30ed\u30b8\u30f3\u306e\u6295\u4e0e\u306f\u3001\u30d7\u30e9\u30bb\u30dc\u7fa4\u3068\u6bd4\u8f03\u3057\u3066\u3001\u814e\u81d3\u75c5\u306e\u9032\u884c\u307e\u305f\u306f\u5fc3\u8840\u7ba1\u7cfb\u306e\u539f\u56e0\u306b\u3088\u308b\u6b7b\u4ea1\u306e\u30ea\u30b9\u30af\u309228\uff05\u6709\u610f\u306b\u4f4e\u4e0b\u3055\u305b\u305f\u3002\u3042\u3089\u3086\u308b\u539f\u56e0\u306b\u3088\u308b\u5165\u9662\u3082\u30a8\u30f3\u30d1\u30b0\u30ea\u30d5\u30ed\u30b8\u30f3\u7fa4\u3067\u30d7\u30e9\u30bb\u30dc\u7fa4\u3088\u308a\u6709\u610f\u306b\u5c11\u306a\u304b\u3063\u305f\u3002 <\/p>\n

14\uff05\u3001p\uff1d0.003\uff09\u3067\u3042\u3063\u305f\uff08\u88681\uff09\u3002\u30b5\u30d6\u30b0\u30eb\u30fc\u30d7\u89e3\u6790\u306b\u3088\u308b\u3068\u3001\u30a8\u30f3\u30d1\u30b0\u30ea\u30d5\u30ed\u30b8\u30f3\u6cbb\u7642\u306e\u52b9\u679c\u306f\u7121\u4f5c\u70ba\u5316\u6642\u306e\u7cd6\u5c3f\u75c5\u3084eGFR\u306e\u6709\u7121\u306b\u304b\u304b\u308f\u3089\u305a\u4e00\u8cab\u3057\u3066\u3044\u305f\u3002 <\/p>\n

 <\/p>\n

\u88681. \u4e3b\u8981\u30a2\u30a6\u30c8\u30ab\u30e0\u304a\u3088\u3073\u4e8b\u524d\u306b\u898f\u5b9a\u3055\u308c\u305f\u4e3b\u8981\u526f\u6b21\u30a2\u30a6\u30c8\u30ab\u30e0\u306b\u5bfe\u3059\u308b\u30a8\u30f3\u30d1\u30b0\u30ea\u30d5\u30ed\u30b8\u30f3\u306e\u52b9\u679c<\/strong><\/p>\n\n\n\n\n\n\n\n\n\n
\u8ee2\u5e30, n (%)<\/td>\n\u30a8\u30f3\u30d1\u30b0\u30ea\u30d5\u30ed\u30b8\u30f3<\/td>\n\u30d7\u30e9\u30bb\u30dc<\/td>\n\u30cf\u30b6\u30fc\u30c9\u6bd4\uff0895\uff05CI\uff09<\/td>\np\u5024<\/td>\n<\/tr>\n
\u30d7\u30e9\u30a4\u30de\u30ea\u30fc<\/td>\n432 (13.1)<\/td>\n558 (16.9)<\/td>\n0.72 (0.64-0.82)<\/td>\n<0.001<\/td>\n<\/tr>\n
\u30ad\u30fc\u30fb\u30bb\u30ab\u30f3\u30c0\u30ea\u30fc<\/td>\n <\/td>\n <\/td>\n <\/td>\n <\/td>\n<\/tr>\n
\u5fc3\u4e0d\u5168\u306b\u3088\u308b\u5165\u9662\u307e\u305f\u306f\u5fc3\u8840\u7ba1\u7cfb\u306e\u539f\u56e0\u306b\u3088\u308b\u6b7b\u4ea1<\/td>\n131 (4.0)<\/td>\n152 (4.6)<\/td>\n0.84 (0.67-1.07)<\/td>\n0.15<\/td>\n<\/tr>\n
\u4f55\u3089\u304b\u306e\u7406\u7531\u306b\u3088\u308b\u5165\u9662<\/td>\n–<\/td>\n–<\/td>\n0.86 (0.78-0.95)<\/td>\n0.003<\/td>\n<\/tr>\n
\u4f55\u3089\u304b\u306e\u539f\u56e0\u306b\u3088\u308b\u6b7b\u4ea1<\/td>\n148 (4.5)<\/td>\n167 (5.1)<\/td>\n0.87 (0.70-1.08)<\/td>\n0.21<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n
\u8457\u8005\u7d50\u8ad6<\/strong>
\u75be\u60a3\u9032\u884c\u306e\u30ea\u30b9\u30af\u3092\u6709\u3059\u308b\u5e45\u5e83\u3044CKD\u60a3\u8005\u306b\u304a\u3044\u3066\u3001\u30a8\u30f3\u30d1\u30b0\u30ea\u30d5\u30ed\u30b8\u30f3\u7642\u6cd5\u306f\u30d7\u30e9\u30bb\u30dc\u306b\u6bd4\u3079\u3001\u814e\u75be\u60a3\u306e\u9032\u884c\u307e\u305f\u306f\u5fc3\u8840\u7ba1\u7cfb\u306e\u539f\u56e0\u306b\u3088\u308b\u6b7b\u4ea1\u306e\u30ea\u30b9\u30af\u3092\u4f4e\u4e0b\u3055\u305b\u305f\u3002<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
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\u30b3\u30e1\u30f3\u30c8<\/strong><\/p>\n

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\u53c2\u8003\u6587\u732e<\/strong><\/td>\n1.Perkovic V, Jardine MJ, Neal B, et al. CREDENCE Trial Investigators.Canagliflozin and renal outcomes in type 2 diabetes and nephropathy.N Engl J Med 2019;380:2295-306.
2.Heerspink HJL, Stef\u00e1nsson BV, Correa-Rotter R, et al. DAPA-CKD Trial Committees and Investigators.\u6162\u6027\u814e\u81d3\u75c5\u60a3\u8005\u306b\u304a\u3051\u308b\u30c0\u30d1\u30b0\u30ea\u30d5\u30ed\u30b8\u30f3\u3002N Engl J Med 2020;383:1436-46.
3.Nuffield Department of Population Health Renal Studies Group and the SGLT2 inhibitor Meta-Analysis Cardio-Renal Trialists’ Consortium.\u30ca\u30c8\u30ea\u30a6\u30e0\u30b0\u30eb\u30b3\u30fc\u30b9\u5171\u8f38\u9001\u4f532\u963b\u5bb3\u85ac\u306e\u814e\u81d3\u8ee2\u5e30\u306b\u5bfe\u3059\u308b\u52b9\u679c\u306b\u5bfe\u3059\u308b\u7cd6\u5c3f\u75c5\u306e\u5f71\u97ff\uff1a\u5927\u898f\u6a21\u30d7\u30e9\u30bb\u30dc\u5bfe\u7167\u8a66\u9a13\u306e\u5171\u540c\u30e1\u30bf\u89e3\u6790\u3002Lancet 2022; 400:1788-801. <\/td>\n<\/tr>\n
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