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

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 tiers—low, moderate, high, and very high—based 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.

Key words: Sodium-glucose transporter 2 inhibitors, Chronic kidney disease, Risk stratification, Diagnostic and treatment guideline, Physician-patient shared decision-making