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Prescribing Patterns of Sodium-Glucose Cotransporter-2 Inhibitors in Patients with CKD: A Cross-Sectional Registry

Min Zhuo1,2, Jiahua Li1, Leo F Buckley3

  • 1Division of Renal Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.

Kidney360
|May 18, 2022
PubMed
Abstract

Insights

Sodium-glucose cotransporter-2 inhibitors (SGLT-2i) show promise for chronic kidney disease (CKD) patients. However, real-world SGLT-2i prescription rates remain low, especially in those without diabetes.

Area of Science:

  • Nephrology
  • Pharmacology
  • Real-world evidence

Background:

  • Sodium-glucose cotransporter-2 inhibitors (SGLT-2i) are established renoprotective agents for chronic kidney disease (CKD).
  • Real-world data on SGLT-2i prescribing patterns in diverse CKD populations are limited.

Purpose of the Study:

  • To assess the adoption and identify factors associated with SGLT-2i prescription in adults with stages 3-5 CKD.
  • To compare SGLT-2i utilization in CKD patients with and without diabetes.

Main Methods:

  • Cross-sectional analysis of 72,240 adult CKD patients from the Mass General Brigham (MGB) CKD registry (March 2021).
  • Multivariable logistic regression models were used to evaluate factors influencing SGLT-2i prescription.

Main Results:

  • Overall SGLT-2i prescription was 6% in diabetic CKD patients and 0.3% in nondiabetic CKD patients.
  • Factors associated with higher SGLT-2i prescription included younger age, Black race, male sex, heart failure history, cardiovascular medication use, and specialist visits.
  • In diabetic CKD patients, advanced stage was linked to lower odds, while urine dipstick testing and subspecialist visits were linked to higher odds of SGLT-2i use.

Conclusions:

  • SGLT-2i prescription rates are notably low within the real-world CKD population.
  • Prescription patterns differ significantly between diabetic and nondiabetic CKD patients, highlighting a gap in utilization for the latter group.
Keywords:
chronic kidney disease (CKD)diabetesprescribing patternsregistry analysissodium-glucose cotransporter-2 inhibitors (SGLT-2i)

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