Sodium-Glucose Cotransport Protein 2 Inhibitors in Patients With Type 2 Diabetes and Acute Kidney Disease
Authors' conclusion
In this cohort study of patients with type 2 diabetes and AKD, administration of SGLT-2is was associated with a significant reduction in all-cause mortality, MAKEs, and MACEs when compared with nonuse, underscoring the importance of SGLT-2is in care after acute kidney injury. These findings emphasize the potential benefits of SGLT-2is in managing AKD and mitigating the risks of major cardiovascular and kidney diseases.
Study context
- Population
- Patients with T2D and acute kidney disease (AKD); mean (SD) age 67.1 (16.4) years; 51.8% men; TriNetX data 2002–2022before matching
- Participants
- 230,366 patients
- Exposure
- SGLT2i use vs nonuse
- SGLT-2i usersn = 5,319
- Outcome
- Mortality, MAKEs and MACE
Methodological detailspropensity-score matched, global health care data (TriNetX)
- Propensity-score matched
- Global health care data (TriNetX)
Main finding
As reported in the abstract
Estimate (95% CI)
SGLT-2i usersvs Nonusers
aHR (mortality) 0.69(0.62–0.77)
SGLT-2i usersvs Nonusers
aHR (MAKEs) 0.62(0.56–0.69)
SGLT-2i usersvs Nonusers
aHR (MACE) 0.75(0.65–0.88)
- Between SGLT-2i users and Nonusers · after propensity score matching
- absolute difference (mortality) 9.7%
- Between SGLT-2i users and Nonusers · after propensity score matching
- absolute difference (major adverse kidney events (MAKEs)) 11.5%
- Between SGLT-2i users and Nonusers · after propensity score matching
- absolute difference (MACE) 12.3%
Observational data: associations, not effects.
Further findings
External validation (multicenter cohort, 1233 SGLT-2i users with AKD)
- Confirmed the observed beneficial outcomes
Subgroups: no hypertension, advanced CKD, no other hypoglycemic agents
- Risk reduction with SGLT-2is remained significant
Original publication
Sodium-Glucose Cotransport Protein 2 Inhibitors in Patients With Type 2 Diabetes and Acute Kidney Disease. JAMA Netw Open. Published 2 January 2024. doi:10.
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