SGLT-2 inhibitors tied to lower risk of End-Stage Renal Disease, Finds Study

Many randomized trials have demonstrated a lower risk of cardiovascular (CV) events with sodium-glucose cotransporter-2 inhibitors (SGLT-2i) in patients with type 2 diabetes (T2D) at high CV risk. Also, prior real-world data suggested similar SGLT-2i effects in T2D patients with a broader risk profile, but these studies focused on heart failure and death.

However, real-world evidence from routine clinical practice elucidating the effects of sodium-glucose cotransporter-2 inhibitors (SGLT-2i) on renal outcomes and mortality in patients with type 2 diabetes (T2D) is limited. Hence, Eun Sil Koh and colleagues from the Division of Nephrology, Department of Internal Medicine, Yeouido St. Mary's Hospital, Seoul, Republic of Korea conducted the present study on Korean patients with T2D.

Using data from the Korean National Health Insurance Service database, the authors studied a total of 701,674 patients who were identified with T2D. "We divided these patients into new-users of SGLT-2i and new-users of other glucose-lowering drugs (oGLD). Using propensity scores, patients in the two groups were matched 1:1. We examined the risk of end-stage renal disease (ESRD) and all-cause death", Koh describes.

Out of the total sample size, 45,016 patients were included in each group, and baseline characteristics were well-balanced between all groups.

The key findings observed were-

1. Use of SGLT-2i versus oGLD was associated with a lower risk of ESRD and all-cause death
2. In a subgroup analysis by eGFR, initiation of SGLT2i vs oGLD was associated with a lower risk of progression to ESRD among patients with eGFR 60-90 and <60 ml/min/1.73m² and lower risk of all-cause death associated with SGLT-2i versus oGLD in patients with eGFR ≥90 and 60-90 ml/min/1.73m².

Therefore, the authors concluded that "in this large nationwide study of Korean patients with T2D, initiation of SGLT-2i vs oGLD was associated with a lower risk of ESRD and all-cause death."