Is glomerular filtration rate (GFR) decline induced by SGLT2 inhibitor of clinical importance?
Authors' conclusion
Our main finding is that after initiating a SGLT2 inhibitor based therapy an exaggerated decline in mGFR was related with improved vascular compliance of large arteries reflecting the pharmacologic effects of SGLT2 inhibitor in the renal and systemic vascular bed. Second, in a single patient with T2D, eGFR may not be an appropriate parameter to assess the true change of renal function after receiving SGLT2 inhibitor based therapy.
Study context
- Population
- Patients with T2D
- Participants
- 65 patients
- Comparison
- Empagliflozin + linagliptin vs metformin + insulin
- SGLT2 inhibitor based treatmentn = 34
- non-SGLT2 inhibitor based treatmentn = 31reference
Primary result
As reported in the abstract
Correlation of change in mGFR with change in PWV · 12 weeks
| Group | R (change in measured GFR (mGFR) vs change in pulse wave velocity (PWV)) | p | R adjusted for change in systolic blood pressure (BP) and heart rate | p (adjusted) |
|---|---|---|---|---|
| SGLT2 inhibitor based treatment | 0.476 | p = 0.005 | 0.422 | p = 0.018 |
SGLT2 inhibitor based treatment
R (change in measured GFR (mGFR) vs change in pulse wave velocity (PWV))0.476
pp = 0.005
R adjusted for change in systolic blood pressure (BP) and heart rate0.422
p (adjusted)p = 0.018
Further findings
| Outcome | SGLT2i-based | Non-SGLT2i-based |
|---|---|---|
| Correlation of change in mGFR with change in eGFR · 12 weeks | ||
| R | −0.148 | 0.138 |
| p | p = 0.404 | p = 0.460 |
Change in mGFR and estimated GFR (eGFR) · 12 weeks
- Both mGFR and eGFR decreased significantly after initiating treatment
Correlation of change in mGFR with change in eGFR · 12 weeks
- No correlation in either group
Original publication
Is GFR decline induced by SGLT2 inhibitor of clinical importance? Cardiovasc Diabetol. Published 29 May 2024. doi:10.
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