Sodium–Glucose Cotransporter-2 Inhibitors and the Risk for Dialysis and Cardiovascular Disease in Patients With Stage 5 Chronic Kidney Disease
Main finding · DialysisResult — go to the resultHazard ratio 0.34 95% CI 0.27–0.43Authors' conclusion
This emulated target trial showed that SGLT2i use was associated with a lower risk for dialysis, cardiovascular events, DKA, and AKI than no SGLT2i use in patients with T2D and stage 5 CKD.
Study context
- Population
- Patients with T2D and stage 5 Chronic Kidney Disease (CKD), Taiwan's National Health Insurance Research Database, 1 May 2016 to 31 October 2021
- Participants
- 23,854 vs 23,892
- Comparison
- SGLT2i use vs no SGLT2i use
- SGLT2i usersn = 23,854
- SGLT2i nonusersn = 23,892reference
- Outcome
- Dialysis
Methodological detailssequential target trial emulation, conditional Cox proportional hazards models
- Sequential target trial emulation
- Conditional Cox proportional hazards models
Main finding
As reported in the abstract
Hazard ratio
0.34
95% CI 0.27–0.43
SGLT2i usersvs SGLT2i nonusers
HR 0.34 (95% CI 0.27–0.43)
Further findings
| Outcome | HR (CI) | |
|---|---|---|
| Hospitalization for HFIntention-to-treat model | 0.80 (0.73–0.86) | |
| Acute MIIntention-to-treat model | 0.61 (0.52–0.73) | |
| All-cause mortalityIntention-to-treat model | 1.11 (0.99–1.24) | |
| 0.512Hazard ratio (log scale) |
Long-term dialysis (Kaplan-Meier curves and subgroup analyses)
- Initiation of an SGLT2i in stage 5 CKD associated with lower risk for long-term dialysis than no SGLT2i use
Safety
| Outcome | HR (CI) | |
|---|---|---|
| DKAIntention-to-treat model | 0.78 (0.71–0.85) | |
| Acute kidney injuryIntention-to-treat model | 0.80 (0.70–0.90) | |
| 0.512Hazard ratio (log scale) |
Original publication
Sodium–Glucose Cotransporter-2 Inhibitors and the Risk for Dialysis and Cardiovascular Disease in Patients With Stage 5 Chronic Kidney Disease. Ann Intern Med. Published 30 April 2024. doi:10.
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