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Impact of SGLT2 Inhibitors on Renal Function in Type 2 Diabetic Patients with Coronary Artery Disease Undergoing
Roopa Satyanarayan Basutkar1, Rasheal Maria Cutinha1, Varshini Sathish1
1Department of Pharmacy Practice, Nitte (Deemed to be University), NGSM Institute of Pharmaceutical Sciences (NGSMIPS), Mangalore, Karnataka, India.
Background:
Contrast agents directly cause kidney toxicity in patients who are candidates for percutaneous intervention having cardiovascular disease with type 2 diabetes.
Aims:
This meta-analysis aims to assess the effects of SGLT2i on renal function in individuals undergoing percutaneous intervention.
Methods:
The databases used for the search included Google Scholar, PubMed, Cochrane Central Registry of Controlled Trials, and Scopus. We considered randomized controlled and observational studies published from January, 2013, to August, 2023. Eligibility to include the studies was assessed independently. The Cochrane modified data extraction form and Joanna Briggs Institute were used to extract the data. The quality of the studies was evaluated using the Cochrane risk of bias tool and the Newcastle-Ottawa scale. The GradePro software was used to measure the certainty of the evidence.
Results:
The pooled estimate showed a substantial reduction in serum creatinine levels at 48 and 72 hours post-PCI who received SGLT2i (MD -9.57; 95% CI -18.36, -0.78; p-value 0.03 and MD - 14.40; 95% CI -28.57, -0.22; p-value 0.05). There was a decrease in the occurrence of the CI-AKI among SGT2i users (RR: 0.46; 95% CI: 0.32, 0.67; p value< 0.0001). No substantial difference was observed in the number of patients requiring hemodialysis; however, a lower proportion of patients among SGLT2i users required hemodialysis (RR: 0.88; 95% CI: 0.19, 4.07; p-value = 0.87).
Conclusion:
The use of SGLT2i confers substantial beneficial effects on kidney function and reduces the occurrence of contrast-induced acute kidney injury among diabetes patients undergoing PCI procedures with cardiovascular disease.
Insights
Sodium-glucose cotransporter 2 inhibitors (SGLT2i) significantly improve kidney function and reduce contrast-induced acute kidney injury (CI-AKI) in patients with cardiovascular disease and type 2 diabetes undergoing percutaneous intervention (PCI). This meta-analysis confirms SGLT2i
Area of Science:
- Nephrology
- Cardiology
- Endocrinology
Background:
- Contrast agents used in percutaneous intervention (PCI) pose a risk of kidney toxicity, particularly in patients with cardiovascular disease and type 2 diabetes.
- Acute kidney injury (AKI) is a significant concern following PCI in this vulnerable patient population.
Purpose of the Study:
- To conduct a meta-analysis assessing the renal protective effects of Sodium-glucose cotransporter 2 inhibitors (SGLT2i) in patients undergoing PCI.
- To evaluate the impact of SGLT2i on serum creatinine levels and the incidence of contrast-induced acute kidney injury (CI-AKI).
Main Methods:
- A comprehensive meta-analysis of randomized controlled and observational studies published between January 2013 and August 2023.
- Searches were conducted across major databases including Google Scholar, PubMed, Cochrane, and Scopus.
- Study quality was rigorously assessed using established tools like the Cochrane risk of bias tool and Newcastle-Ottawa scale, with evidence certainty measured by GradePro.
Main Results:
- SGLT2i use was associated with a significant reduction in serum creatinine levels at 48 and 72 hours post-PCI.
- A notable decrease in the occurrence of CI-AKI was observed in patients treated with SGLT2i (RR: 0.46; p<0.0001).
- While no substantial difference in the need for hemodialysis was found, a lower proportion of SGLT2i users required this intervention.
Conclusions:
- SGLT2i demonstrate significant renoprotective benefits in patients with type 2 diabetes and cardiovascular disease undergoing PCI.
- The use of SGLT2i effectively reduces the incidence of CI-AKI in this high-risk group.
- SGLT2i represent a valuable therapeutic option for preserving kidney function in patients undergoing PCI procedures.
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