Sodium–glucose cotransporter 2 inhibitors in type 2 diabetes patients with renal function impairment slow the annual renal function decline, in a real clinical practice

• DOI: 10.1111/jdi.13502
• Publication Date: 2021-01-13T23:29:08Z
• Authors: Taro Hirai; Munehiro Kitada; Itaru Monno; Erina Oda; Yoshihiro Hayashi; Keiji Shimada; Yuta Takagaki; Yoshio Ogura; Mizue Fujii; Kazunori Konishi; Masaru Sakurai; Atsushi Nakagawa; Daisuke Koya
• Keywords: Sodium–glucose cotransporter 2 inhibitor; Blood Glucose; Male; Articles; RC648-665; Kidney; Prognosis; Diseases of the endocrine glands. Clinical endocrinology; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Diabetes Mellitus, Type 2; Humans; Diabetic Nephropathies; Female; Diabetic kidney disease; Practice Patterns, Physicians'; Annual estimated glomerular filtration rate decline; Sodium-Glucose Transporter 2 Inhibitors; Biomarkers; Aged; Follow-Up Studies; Glomerular Filtration Rate; Retrospective Studies

AbstractAims/IntroductionThe aim of this study was to elucidate whether sodium–glucose cotransporter 2 inhibitors (SGLT2is) treatment has any renoprotective effect for type 2 diabetes mellitus patients with an estimated glomerular filtration rate (eGFR) of <60 mL/min/1.73 m2 in clinical practice.Materials and MethodsWe evaluated the annual eGFR slope in 85 type 2 diabetes mellitus patients with renal impairment, treated with SGLT2is ≥2 years. Each patient's eGFR was <60 mL/min/1.73 m2 at the start of SGLT2is therapy. The calculation of the annual change in eGFR for each patient was obtained by acquired eGFR data before and after 2 years of the initial SGLT2is administration, followed by analysis of the changes in the mean eGFR slope.ResultsThe participants' mean age was 72.0 ± 9.4 years, and the mean eGFR was 47.1 ± 9.7 mL/min/1.73 m2 at the start of additional treatment with SGLT2is. The mean annual eGFR slope after SGLT2is administration (−0.11 ± 0.20 mL/min/1.73 m2/year) was significantly slower than before SGLT2is administration (−2.93 ± 0.59 mL/min/1.73 m2/year; P < 0.0001). Additionally, SGLT2is treatment slowed the annual decline of eGFR, independent of the levels of both the initial eGFR and albuminuria levels before SGLT2is therapy was started. In the patient groups who showed an annual eGFR decline of ≥3 and 1–3 mL/min/1.73 m2, there was a significant slowing of the decline after SGLT2is therapy, compared with before the treatment (P < 0.001, respectively).ConclusionsSGLT2is administration slows the decline observed in the annual renal function in type 2 diabetes mellitus patients with eGFR of <60 mL/min/1.73 m2 in clinical practice.