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Las biguanidas se asocian con una disminución de la mortalidad temprana y el riesgo de lesión renal aguda en

Mari Sugimoto1, Hiroaki Kikuchi2, Eisei Sohara3

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Clinical and experimental nephrology
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El uso de biguanida (BG) en pacientes con COVID-19 se relacionó con un menor riesgo de muerte en el hospital y lesión renal aguda (AKI). Este medicamento común para la diabetes muestra potencial para mejorar los resultados de la COVID-19.

Palabras clave:
Lesiones renales agudasBiguánidosEl COVID-19La mortalidad

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Área de la Ciencia:

  • Farmacología
  • Enfermedades infecciosas
  • Nefrología

Sus antecedentes:

  • La biguanida (BG) es un medicamento para reducir la glucosa oral ampliamente prescrito con potencial para un uso terapéutico más amplio.
  • La pandemia de COVID-19 puso de relieve la necesidad de tratamientos efectivos y de bajo costo.
  • Las variadas tasas de morbilidad y mortalidad subrayan la importancia de identificar intervenciones beneficiosas.

Objetivo del estudio:

  • Investigar la asociación entre el uso oral de biguanida y los resultados clínicos en pacientes con COVID-19.
  • Evaluar el impacto de la biguanida en la mortalidad hospitalaria y la lesión renal aguda (IRA) en esta población de pacientes.

Principales métodos:

  • Análisis retrospectivo de los datos de pacientes hospitalizados de Japón (septiembre de 2021 - marzo de 2023).
  • La inclusión de 168.370 pacientes de entre 20 y 79 años con diabetes mellitus y COVID-19 tratados con agentes antidiabéticos orales.
  • Comparación de resultados (mortalidad hospitalaria a los 100 días, incidencia de IAC) entre usuarios de biguanida y no usuarios utilizando modelos de regresión logística y de riesgos proporcionales de Cox, con coincidencia de puntuación de propensión.

Principales resultados:

  • El uso de biguanida se asoció con una mortalidad hospitalaria significativamente menor (1,18% frente a 2,41%, P < 0,001).
  • La incidencia de lesión renal aguda (IRA) se redujo significativamente en el grupo de biguanida (0,66% frente a 1,12%, P < 0,001).
  • El análisis con puntuación de propensión mostró una tasa de supervivencia significativamente mejor en el grupo de biguanida (HR ajustada, 0,619; P < 0,001).

Conclusiones:

  • El uso oral de biguanida puede estar asociado con una reducción de la mortalidad hospitalaria en pacientes con COVID-19.
  • El tratamiento con biguanida también puede reducir el riesgo de lesión renal aguda (IRA) durante la hospitalización por COVID-19.
  • Estos hallazgos sugieren un papel protector potencial para las biguanidas en el manejo de pacientes con COVID-19 con diabetes.