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The following is a summary of “Effects of Sodium-Glucose Cotransporter-2 Inhibitors on Kidney Outcomes across Baseline Cardiovascular-Kidney-Metabolic Conditions: A Systematic Review and Meta-Analyses,” published in the September 2024 issue of Nephrology by Siddiqi et al.
The impact of sodium-glucose cotransporter-2 inhibitors (SGLT2i) on kidney outcomes in patients with changing combinations of heart failure (HF), chronic kidney disease (CKD), and type 2 diabetes mellitus had not been quantified.
Researchers conducted a retrospective study to quantify the effects of SGLT2i on kidney outcomes in patients with varying combinations of HF, CKD, and type 2 diabetes mellitus.
They searched PubMed and Scopus (December 2023) for primary and secondary analysis of placebo-controlled trials of SGLT2i in individuals with HF, CKD, or type 2 diabetes mellitus. Outcomes were composite kidney endpoint (combination of estimated glomerular filtration rate (eGFR) <15 mL/min/1.73 m2, sustained doubling of serum creatinine, changing percent in eGFR, and for kidney replacement therapy), rate of eGFR slope decline and albuminuria progression, HR and mean differences with their 95% CI were extracted onto an excel sheet.
The results showed 11 trials (n=80,928 patients), compared with the placebo, SGLT2i less the risk of the composite kidney endpoint by 41% (HR 0.59; 95%CI 0.42-0.83) in HF with reduced ejection fraction, 36% (HR 0.64;95%CI 0.55-0.73) in CKD, and 38% (HR 0.62;95%CI 0.56-0.69) in type 2 diabetes mellitus. An identical pattern of benefit was observed in combinations of these comorbidities, as well as in patients without baseline HF, CKD, or type 2 diabetes mellitus. The SGLT2i slowed the rate of eGFR slope decline and decreased the risk of sustained doubling of serum creatinine by 36% (HR 0.64; 95%CI 0.56-0.72) in the overall population, and a consistent effect on kidney outcomes was noticed in most subpopulations with available data.
They concluded that SGLT2i improved kidney outcomes in cohorts with HF, CKD, and type 2 diabetes mellitus, and the effects were consistent across patients with different combinations of these comorbidities.
Source: journals.lww.com/jasn/abstract/9900/effects_of_sodium_glucose_cotransporter_2.416.aspx
