Early Sodium-Glucose Cotransporter-2 Inhibitor Use After Acute Kidney Injury in Type 2 Diabetes
Main finding · Adverse kidney events (dialysis reinitiation, incident end-stage kidney disease or eGFR <15 mL/min/1.73 m²); all-cause mortality; MACEResult — go to the resultAdjusted hazard ratio 0.62 95% CI 0.46–0.83Authors' conclusion
In adults with type 2 diabetes recovering from AKI-D, SGLT-2 inhibitor prescription within 30 days after discharge was associated with fewer adverse kidney events than prescription at 31 to 90 days, without significant differences in mortality, cardiovascular events, or recorded short-term safety outcomes.
Study context
- Population
- Adults with T2D hospitalized for dialysis-requiring acute kidney injury (AKI-D), dialysis discontinued after discharge, no SGLT2i in prior year; TriNetX Global Collaborative Network EHRs, 2015–2024before matching
- Participants
- 4,406 adults
- Exposure
- SGLT2i prescription within 30 days vs 31 to 90 days after discharge
- Earlyn = 1,912
- Laten = 1,912reference
- Outcome
- Adverse kidney events (dialysis reinitiation, incident end-stage kidney disease or eGFR <15 mL/min/1.73 m²), all-cause mortality and MACE
- Follow-up
- Mean 3.4 years (IQR, 1.1-3.3 years)
Methodological detailstarget trial emulation, 90-day landmark design, 1:1 propensity score matching
- Target trial emulation
- 90-day landmark design
- 1:1 propensity score matching
Main finding
As reported in the abstract
Adverse kidney events (dialysis reinitiation, incident end-stage kidney disease or eGFR <15 mL/min/1.73 m²); all-cause mortality; MACE
Adjusted hazard ratio
0.62
95% CI 0.46–0.83
Events by group
Earlyvs Late
aHR 0.62 (95% CI 0.46–0.83)
- All-cause mortality did not differ significantly
- aHR 1.06; 0.84-1.35; P = .63 (95% CI, P)
- MACE did not differ significantly
- aHR 1.03; 0.80-1.34; P = .81 (95% CI, P)
Observational data: associations, not effects.
Safety
- Recorded 6-month safety outcomes were similar
Original publication
Early Sodium-Glucose Cotransporter-2 Inhibitor Use After Acute Kidney Injury in Type 2 Diabetes. JAMA Netw Open. Published 3 August 2026. doi:10.
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