RESUMO
Dapagliflozin, a sodium-glucose cotransporter 2 inhibitor (SGLT2i), has shown demonstrated benefits for renal and cardiovascular outcomes in large clinical trials. However, short-term concerns regarding its impact on renal function and electrolyte balance exist. This study aimed to evaluate the short-term effects of dapagliflozin on renal function and electrolyte balance in patients newly prescribed the medication. A retrospective analysis of 246 patients who initiated dapagliflozin therapy was conducted. Serum creatinine, sodium, and potassium levels were measured at baseline (before dapagliflozin) and 5-8 days after initiation (endpoint). A Wilcoxon signed-rank test, Pearson's chi-square test, and Fischer's exact test were used for the data analysis. Glycemia and sodium levels were significantly higher at the baseline compared to the endpoint (p < 0.001). Conversely, creatinine and potassium levels were significantly higher at the endpoint than at the baseline (p < 0.001). The prevalence of hyponatremia and hyperkalemia were increased at the endpoint (17.5% vs. 10.2% and 16.7% vs. 8.9%, respectively). Although not statistically significant, a trend towards increased hyponatremia with the co-administration of furosemide was observed (p = 0.089). No significant association was found between potassium-sparing medications (p > 0.05) and hyperkalemia, except for angiotensin receptor blockers (p = 0.017). The combination of dapagliflozin and furosemide significantly increased the risk of acute kidney injury (AKI) at the endpoint (p = 0.006). Age, gender, and chronic kidney disease status did not significantly influence the occurrence of AKI, hyponatremia, or hyperkalemia (p > 0.05). These findings emphasize the importance of the close monitoring of renal function and electrolyte balance, particularly in the early stages of dapagliflozin therapy, especially in patients receiving diuretics or renin-angiotensin-aldosterone system inhibitors.
RESUMO
(1) Background: Sensory processing disorder is now recognised as a core feature of autism spectrum disorder that influences children's adaptive behaviours, which, in turn, may interfere with their participation in life situations. This study describes the process of developing a technological platform, in the form of an app, to help families regulate children with ASD, aged 3-6 years old, by applying sensory strategies to improve the child's participation in daily routines in the home context. (2) Methods: A focus group formed by four specialised occupational therapists who intervene with children with ASD was selected in order to understand and discuss content that should be included in the app. At a later stage, a group of three was involved to ensure quality and veracity in technological platform elaboration. (3) Results: The purpose of the app, named Regul-A, is to help parents regulate children with ASD regarding their participation in home routines. The sensory strategies provided by the focus group in the three major occupations of the child were the first results obtained, followed by the development of the app structure. (4) Conclusions: The next phase of the study will be the use of the platform by families of children with ASD and occupational therapists. It is believed that, in the future, Regul-A will be used as a tool to gather, analyse and manage data on the occupational performance of children with ASD in the home context, particularly for activities of daily living, sleep, rest and play, facilitating the implementation of strategies and the sharing of information between parents and occupational therapists.