时间标签：数据日期 2026-11-05 · 生成时间 2026-11-05 05:30（Asia/Shanghai）｜ 检索窗口 PubMed edat 2026/11/02 – 2026/11/06 ｜ 情报发生日期 2026-11-05
研究问题
Therefore, the evidence supporting SGLT2 inhibitor use in CKD is derived predominantly from younger patients with fewer comorbidities.In this context, we hypothesized that greater renal and vascular injury would be associated with a worse physical performance and a higher burden of prefrailty in older hypertensive patients with CKD.；This analysis demonstrated significantly worse physical performance among patients with eGFR <60 mL/min/1.73 m2 compared with those with eGFR ≥60 mL/min/1.73 m2 (P = 0.0003; Figure 3).Having established that renal function markers are associated with physical performance, we next examined whether dapagliflozin treatment was independently associated with frailty outcomes after accounting for potential confounders.；Future investigations and randomized clinical trials based on larger multicenter cohorts with extended follow-up are warranted to validate our observations and to determine whether early, targeted strategies aimed at vascular and renal protection can effectively prevent frailty progression.MethodsSex as a biological variable.We examined both female and male individuals.Study design.The DAPA-FORTRESS study involves consecutive prefrail older patients with hypertension and CKD, recruited between March 2021 and September 2023 at the ASL of Avellino, Italy.
方法
Therefore, the evidence supporting SGLT2 inhibitor use in CKD is derived predominantly from younger patients with fewer comorbidities.In this context, we hypothesized that greater renal and vascular injury would be associated with a worse physical performance and a higher burden of prefrailty in older hypertensive patients with CKD.；Furthermore, we posited that treatment with dapagliflozin would be associated with a reduced progression of frailty, potentially through attenuation of systemic vascular and renal injury.；To test these hypotheses, we designed an observational prospective study named DAPA-FORTRESS (DAPAgliflozin and Frailty prOgression in hypeRTension and chRonic kidnEy diSeaSe).ResultsA total of 196 prefrail older adults with hypertension and CKD were screened for study participation.
核心结论
This analysis demonstrated significantly worse physical performance among patients with eGFR <60 mL/min/1.73 m2 compared with those with eGFR ≥60 mL/min/1.73 m2 (P = 0.0003; Figure 3).Having established that renal function markers are associated with physical performance, we next examined whether dapagliflozin treatment was independently associated with frailty outcomes after accounting for potential confounders.；Our results suggest that renal biomarkers may serve as particularly powerful indicators of functional reserve in elderly patients.；The consistency and magnitude of the observed associations are clinically meaningful and complements the prespecified frailty subgroup analyses of the DELIVER and DAPA-CKD trials, which demonstrated that dapagliflozin’s efficacy and safety were maintained across the frailty spectrum (39, 40, 42).
局限
However, these relationships should not be interpreted as causal: both renal injury and impaired physical performance may share common underlying drivers (including vascular disease, chronic inflammation, diabetes, and accelerated aging) that independently contribute to both findings.；Nevertheless, vigilant monitoring for volume depletion, hypotension, and genitourinary infections remains warranted in very old patients with CKD (42–44); thus, a personalized and mechanism-oriented therapeutic approach that simultaneously targets blood pressure control, endothelial dysfunction, and downstream vascular complications might be particularly effective in mitigating age-related physical decline (41, 45–49).Several limitations should be acknowledged.；Finally, the high transition rate in the nondapagliflozin group should be interpreted cautiously: while it likely reflects the substantial comorbidity burden of this cohort, it exceeds rates reported in general community-dwelling populations and warrants validation in larger cohorts.
对本项目的价值
中等价值：属「衰弱 / 肌少症功能结局」方向；肌肉骨骼 / 衰弱 / 肌少症栏目可用作本项目文献库与综述素材。 ｜ 价值分 2.9/5（★★★☆☆）
全文来源
PubMed PMC JATS（正文 17,824 字符，题名指纹 0.92，已过 PubMed PMCID 官方关联 + 题名指纹 + 正文长度归属校验）
原文题录
- 中文题名：达格列净减缓高血压合并慢性肾病患者从衰弱前期到衰弱的进展
- 英文标题：Dapagliflozin attenuates progression from prefrailty to frailty in patients with hypertension and chronic kidney disease.
- 期刊与标识：The Journal of clinical investigation · PMID 42969229 · DOI 10.1172/JCI205416 · PMC PMC13722378