Impacts of sacubitril/valsartan sodium table combined with empagliflozin on renal hemodynamics and serum thrombomodulin level in patients with diabetes nephropathy and hypertension

Wei Yinyu; Liu Guoying; Hu Lele; Gao Zhimeng; Zhang Qiaomei; Wang Jinyan; Zhu Kunliang

doi:10.3760/j.issn.1673-4777.2024.03.014

Abstract：Objective To analyze the impacts of sacubitril/valsartan sodium table combined with empagli-flozin on renal hemodynamics and serum thrombomodulin levels in patients with diabetes nephropathy and hypertension.Methods From June 2020 to July 2022,158 patients with diabetes nephropathy and hypertension admitted to Cangzhou Central Hospital,Hebei Province were regarded as the study subjects,and they were grouped into combined treatment group and empagliflozin group,with 79 cases in each group.Empagliflozin group was treated with empagliflozin orally based on conventional treatment,and combined treatment group was treated with sacubitril/valsartan sodium table based on empagliflozin group.Both groups were treated for 6 months.The blood glucose,blood pressure indicators,body mass,renal hemodynamic indicators,renal function indicators,and thrombin regulatory protein levels between the two groups before and after treatment were compared.The clinical efficacy and adverse reactions of two groups were recorded.Results After treatment,the levels of systolic blood pressure,diastolic blood pressure,fasting blood glucose,2 h postprandial blood glucose,glycated hemoglobin,body mass,whole blood high shear viscosity,whole blood low shear viscosity,fibrinogen,platelet aggregation rate,serum creatinine,blood urea nitrogen,urinary protein excretion rate,thrombomodulin of two groups were all lower than those before treatment,the level of estimated glomerular filtration rate of two groups was higher than that before treatment,and the combined treatment group was better than the empagliflozin group(all P＜0.05).The total effective rate of the combined treatment group was higher than that of the empagliflozin group[96.2％(76/79)vs 82.3％(65/79)](P=0.005).The total incidence of adverse reactions of the combined treatment group was lower than that of the empagliflozin group[5.1％(4/79)vs 7.6％(6/79)],but there was no statistically significant difference(P=0.513).Conclusions Sacubitril/valsartan sodium table combined with empagliflozin can reduce blood glucose,blood pressure,and serum thrombomodulin levels in patients with diabetes nephropathy and hyper-tension,reduce renal function damage,improve renal hemodynamics,and improve the therapeutic effect.