Hematocrit elevation after SGLT2 inhibitor administration may be associated with the degree of proximal tubular damage.

The renal protective effects of SGLT2 inhibitors are known to be due to the elimination of glomerular hypertension and improvement of hypoxia and oxidative stress in the proximal tubule. Therefore, this increased hematocrit (ΔHct) level has been hypothesized to indicate restored tubular function and improved renal prognosis. To analyze the relationship between ΔHct and decreased estimated glomerular filtration rate (eGFR) after SGLT2 inhibitor administration backward from medical record data. Data from 206 patients who continued SGLT2 inhibitors for >3 years were analyzed. The decreased eGFR after administration of SGLT2 inhibitors was defined as Slope B. Factors statistically significantly associated with Slope B in multiple regression analysis were systolic blood pressure (sBP) (ß -.211, P = .03), short-term decreased eGFR after SGLT2 inhibitor administration (initial dip) (ß -.235, P = .003), ΔHct (ß -.185, P = .026), and urine protein (ß -.204, P = .015). These findings were the opposite of our hypothesis. ΔHct was not a marker indicating improved renal prognosis and may reflect the extent of the proximal tubular disorder before administering SGLT2 inhibitors.

Treatment of endometrial hyperplasia with a danazol-releasing intrauterine device: a prospective study.

The purpose of the present study was to assess the effect of a danazol-releasing intrauterine device (D-IUD) in the treatment of endometrial hyperplasia. Twenty patients with endometrial hyperplasia including 14 with simple endometrial hyperplasia and 2 with complex endometrial hyperplasia (group A), and 4 with atypical endometrial hyperplasia (group B) were enrolled in the prospective study between August 1999 and December 2003. During and just after the treatment, improvement was seen in all patients. Simple or complex endometrial hyperplasia (group A) demonstrated regression to a normal secretory endometrium (38% of group A), pseudodecidual stromal change (31%) and glandular atrophy (25%), and miscellaneous change (inflammation, necrosis, etc.) (38%). Atypical hyperplasia (group B) demonstrated regression to a normal secretory endometrium (25% of group B), pseudodecidual stromal change (75%), glandular atrophy (50%) and miscellaneous change (granulation) (25%). In group A, 2 women conceived after completion of the treatment. The recurrence rate in patients with endometrial hyperplasia (groups A and B) in the follow- up was 20% and acceptable as compared with other studies. The pretreatment menstrual interval patterns of the patients were maintained peri- and post-treatment. These data indicate that D-IUD therapy might be a novel and effective method for the treatment of endometrial hyperplasia.