Factors affecting the sodium‐glucose cotransporter 2 inhibitors‐related initial decline in glomerular filtration rate and its possible effect on kidney outcome in chronic kidney disease with type 2 diabetes: The Japan Chronic Kidney Disease Database
Authors' conclusion
The concomitant use of renin-angiotensin system inhibitors and diuretics, higher urine protein levels and pre-treatment GFR changes were associated with a larger initial GFR decline. Of these factors, the use of a diuretic had the largest effect. Furthermore, patients with CKD and T2DM experiencing an excessive initial GFR drop might be at a higher risk of adverse kidney outcomes.
Study context
- Population
- Patients with chronic kidney disease (CKD) and T2D newly prescribed an SGLT2i, Japan Chronic Kidney Disease Databaseanalysed
- Participants
- 2,053 patients
- Exposure
- Factors associated with SGLT2i-related initial glomerular filtration rate (GFR) decline; largest-decline quartile vs other quartiles
- Outcome
- Factors affecting the initial GFR drop after SGLT2i initiation
Methodological detailsnationwide database, multivariate linear regression
- Nationwide database
- Multivariate linear regression
Main finding
As reported in the abstract
Factors associated with a larger initial GFR decline (multivariate linear regression)
Concomitant RAS inhibitors, β
−0.609
p = .039
Diuretics, β
−2.298
p < .001
Urinary protein ≥2+, β
−0.936
p = .048
Change in GFR before SGLT2i initiation, β
−0.079
p < .001
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| Composite kidney outcome (GFR decline ≥50% or progression to end-stage kidney disease) · follow-up 1015 days (IQR 532, 1678)Higher incidence in the largest-decline quartile | P < 0.001 |
Original publication
Factors affecting the sodium‐glucose cotransporter 2 inhibitors‐related initial decline in glomerular filtration rate and its possible effect on kidney outcome in chronic kidney disease with type 2 diabetes: The Japan Chronic Kidney Disease Database. Diabetes Obes Metab. Published 8 May 2024. doi:10.
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