S odium‐glucose co‐transporter‐2 inhibitors are associated with kidney benefits at all degrees of albuminuria: A retrospective cohort study of adults with diabetes
Authors' conclusion
SGLT2is may prevent eGFR decline and reduce the risk of adverse kidney events in adults with diabetes and nil or non-severe albuminuria.
Study context
- Population
- Adults with diabetes with varying levels of albuminuria (mild, moderate or severe); SGLT2i users median age 57.9 years, female 40.9%, mostly nil/mild albuminuria (70.7%)matched cohort
- Exposure
- SGLT2i vs DPP-4i
- SGLT2in = 19,238
- Outcome
- eGFR change; composite kidney outcome (>40% loss of eGFR, kidney replacement therapy or death from kidney causes); all-cause mortality
Methodological detailsadministrative data, matched 1:2 on diabetes therapy, chronic kidney disease (CKD) stage, albuminuria and time-conditional propensity score
- Administrative data
- Matched 1:2 on diabetes therapy, CKD stage, albuminuria and time-conditional propensity score
Main finding
As reported in the abstract
eGFR change, composite kidney outcome
Incidence rate ratio (95% CI)P value
SGLT2ivs DPP4icomposite adverse kidney outcome
0.58(0.47–0.71)
P < 0.001- SGLT2i vs DPP4i · greater acute decline with SGLT2i
- acute (≤60 days) estimated glomerular filtration rate (eGFR) decline 1.36 mL/min/1.73m2 (95% CI 0.98–1.74); P < 0.001
- DPP4i vs SGLT2i · less annual eGFR loss with SGLT2i
- annual eGFR loss thereafter 1.04 mL/min/1.73m2 (95% CI 0.93–1.15); P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | IRR (CI) | P value | |
|---|---|---|---|
| All-cause mortality | 0.82 (0.66–1.01) | P = 0.06 | |
| 0.512Incidence rate ratio (log scale) |
Nil/mild albuminuria subgroup
- Outcomes were similar considering only those with nil/mild albuminuria
Original publication
S odium‐glucose co‐transporter‐2 inhibitors are associated with kidney benefits at all degrees of albuminuria: A retrospective cohort study of adults with diabetes. Diabetes Obes Metab. Published 23 November 2023. doi:10.
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