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SGLT-2 inhibitors in chronic peritoneal dialysis patients: a follow-up study
Jia-Wen Lai1, Charles C N Wang2, Che-Yi Chou3,4,5,6
1Division of Nephrology, Asia University Hospital, Taichung, Taiwan.
Background:
Sodium-glucose transporter-2 inhibitors (SGLT-2i) are recommended for use in patients with type 2 diabetes comorbid atherosclerotic cardiovascular disease, heart failure, or chronic kidney disease. Limited reports are currently available for their use in dialysis patients. In an observational, retrospective follow-up study, we reported the clinical characteristics of chronic peritoneal dialysis (PD) patients on SGLT-2i.
Methods:
We enrolled 50 diabetic chronic PD patients, and 11 continued SGLT-2i after PD treatment. We reported the patients' ultrafiltration, HbA1c, urinary tract infection episodes, and venous CO2 during follow-up and compared the differences in these factors between patients with and without SGLT-2i.
Results:
The mean age of the patients was 65 ± 15 years, and 16 (32%) patients were female. The age, gender, heart failure, and primary kidney disease were not different between patients with and without SGLT-2i at enrollment. In an average of 31 months follow-up, patients with SGLT-2i had higher ultrafiltration (1322 ± 200 ml/day vs. 985 ± 415 ml/day, p = 0.013), hemoglobin (11.2 ± 1.7 vs. 10.2 ± 1.7 g/dl), white blood cell count (9.2 ± 3.7 vs. 7.4 ± 2.1 109/L), and a lower venous CO2 (p = 0.036). The urine amount, the overall survival, the technical survival, and the chance of UTI were not different between patients with and without SGLT2i.
Conclusion:
SGLT-2i may increase ultrafiltration volume and hemoglobin levels in chronic PD patients. SGLT-2i did not increase urinary tract infection but was linked to subclinical metabolic acidosis.
What Was Known:
The effect of SGLT-2i in chronic PD patients is not clear?
This Study Adds:
SGLT-2i is associated with increased ultrafiltration, hemoglobin, white blood cell counts, and a decreased CO2 in PD patient.
Potential Impact:
SGLT-2i may increase ultrafiltration in PD patients.
Insights
Sodium-glucose transporter-2 inhibitors (SGLT-2i) may improve ultrafiltration and hemoglobin in peritoneal dialysis (PD) patients. This study found no increase in urinary tract infections but noted a link to subclinical metabolic acidosis.
Area of Science:
- Nephrology
- Endocrinology
- Cardiology
Background:
- Sodium-glucose transporter-2 inhibitors (SGLT-2i) are recommended for type 2 diabetes patients with cardiovascular or kidney disease.
- Limited data exists on SGLT-2i use in dialysis patients.
- This study investigated SGLT-2i in chronic peritoneal dialysis (PD) patients.
Purpose of the Study:
- To evaluate the clinical characteristics and outcomes of chronic PD patients using SGLT-2i.
- To compare ultrafiltration, HbA1c, urinary tract infection (UTI) episodes, and venous CO2 levels between PD patients with and without SGLT-2i.
Main Methods:
- An observational, retrospective follow-up study.
- Enrolled 50 diabetic chronic PD patients; 11 continued SGLT-2i.
- Compared ultrafiltration, HbA1c, UTI, and venous CO2 between SGLT-2i users and non-users.
Main Results:
- SGLT-2i users showed significantly higher ultrafiltration (1322 vs. 985 ml/day) and hemoglobin levels (11.2 vs. 10.2 g/dl).
- White blood cell counts were higher, and venous CO2 was lower in SGLT-2i users.
- No significant differences were observed in urine amount, overall survival, technical survival, or UTI rates.
Conclusions:
- SGLT-2i may enhance ultrafiltration and hemoglobin in chronic PD patients.
- SGLT-2i use was not associated with increased UTI risk.
- A potential link between SGLT-2i and subclinical metabolic acidosis was observed.
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