Use of sodium–glucose cotransporter-2 inhibitors (SGLT2is) is associated with a substantially lower risk for dialysis and cardiovascular disease in patients with type 2 diabetes (T2D) and stage 5 chronic kidney disease (CKD), according to a study published online April 30 in the Annals of Internal Medicine.

Fu-Shun Yen, M.D., from Dr. Yen’s Clinic in Taoyuan, Taiwan, and colleagues used the Taiwan National Health Insurance Research Database to identify 23,854 SGLT2i users and 23,892 SGLT2i nonusers with T2D and stage 5 CKD (from May 1, 2016, to Oct. 31, 2021).

The researchers found that compared with no SGLT2i use, SGLT2i use was associated with lower risks for dialysis (hazard ratio [HR], 0.34; 95 percent confidence interval [CI], 0.27 to 0.43), hospitalization for heart failure (HR, 0.80; 95 percent CI, 0.73 to 0.86), acute myocardial infarction (HR, 0.61; 95 percent CI, 0.52 to 0.73), diabetic ketoacidosis (HR, 0.78; 95 percent CI, 0.71 to 0.85), and acute kidney injury (HR, 0.80; 95 percent CI, 0.70 to 0.90). No differences were seen for the risk for all-cause mortality (HR, 1.11; 95 percent CI, 0.99 to 1.24). A lower risk for long-term dialysis was also seen for initiation of an SGLT2i in stage 5 CKD.

“Sodium-glucose cotransporter-2 inhibitors are likely to be a cornerstone in managing patients at different stages of CKD to reduce the risk for dialysis and cardiovascular disease,” the authors write.

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