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SGLT2 inhibitors reduce the risk of renal failure in CKD stage 5 patients with Type 2 DM

Birdie Huang1, Chieh-Li Yen2,3, Chao-Yi Wu3

  • 1Department of Cardiology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan.

Scientific Reports
|February 18, 2025
PubMed

Insights

Sodium-glucose cotransporter-2 (SGLT2) inhibitors significantly reduced end-stage renal disease risk in type 2 diabetes patients with advanced chronic kidney disease (CKD5). SGLT2 inhibitors did not increase risks for major adverse cardiovascular events or mortality in this population.

Area of Science:

  • Nephrology
  • Endocrinology
  • Pharmacology

Background:

  • Sodium-glucose cotransporter-2 (SGLT2) inhibitors are recognized for their benefits in diabetes and chronic kidney disease (CKD).
  • The specific impact of SGLT2 inhibitors on patients with type 2 diabetes (T2DM) and advanced CKD (CKD stage 5) requires further investigation.

Purpose of the Study:

  • To evaluate the efficacy and safety of SGLT2 inhibitors in T2DM patients diagnosed with CKD stage 5.
  • To assess the effect of SGLT2 inhibitors on the risk of end-stage renal disease (ESRD) and other adverse outcomes.

Main Methods:

  • An observational cohort study utilizing Taiwan's National Health Insurance Research Database (NHIRD).
  • T2DM patients newly identified with CKD5 were propensity score matched (1:4) into SGLT2 inhibitor users and non-users.
  • Outcomes including new-onset ESRD, major adverse cardiovascular events (MACCEs), infection-related hospitalizations, and mortality were compared.

Main Results:

  • SGLT2 inhibitor use was associated with a significantly lower risk of new-onset ESRD (HR 0.59, 95% CI: 0.59-0.74).
  • No significant differences were found in the risks of MACCEs, infection-related hospitalizations, infection-associated mortality, or all-cause mortality between the groups.

Conclusions:

  • SGLT2 inhibitors demonstrate renal protective effects in T2DM patients with CKD stage 5.
  • SGLT2 inhibitors appear safe for use in this population, without an increased risk of cardiovascular events or infections.
Keywords:
CKDDiabetesESRDMACCESGLT2 inhibitor

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