SGLT2 inhibitors lower chronic kidney disease risk in diabetes patients with higher DCSI: Study

Written By :  Medha Baranwal
Medically Reviewed By :  Dr. Kamal Kant Kohli
Published On 2023-01-07 04:30 GMT   |   Update On 2023-01-07 09:25 GMT
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Taiwan: The use of sodium-glucose cotransporter-2 inhibitors (SGLT2Is) significantly lowers the risk of chronic kidney disease (CKD) in type 2 diabetes patients with a higher DCSI (diabetes complications severity index), reveals a recent study published in the Journal of Nephrology.

Wei-Syun Hu from China Medical University in Taichung, Taiwan, and colleagues aimed to investigate the risk of CKD in type 2 diabetes patients with different scores of adapted DCSI who received SGLT2 inhibitors in a retrospective analysis. The DCSI quantifies the severity and presence of complications based on seven body systems or dimensions. It converts laboratory results and diagnostic codes into a 14-level metric quantifying the long-term diabetes effects on seven body systems.

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The analysis included 113,449 patients with type 2 diabetes mellitus (T2DM) from the Taiwan NHIRD (National Health Insurance Research Database). They analyzed data collected from 107,440 patients demonstrating a change in DCSI score of < 1 per year, 2289 patients with a score change of > 2 per year, and 3720 patients with a change in score of 1 to 2 per year.

CKD risk throughout the follow-up period was assessed using Cox proportional hazard models. They were adjusted for age, sex, comorbidities, and medications of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, glucosidase inhibitors, dipeptidyl peptidase-4 inhibitors, biguanides, meglitinides, glucagon-like peptide-1 receptor agonists, insulin, a thiazolidinedione, and sulphonylurea.

The authors reported the following findings:

  • The incidence of chronic kidney disease rose from 18.30 per 1000 person-years in patients with a score change of < 1 per year to 137.55 per 1000 person-years in patients with a score change of > 2 per year.
  • Higher score change (> 2 per year) patients who received SGLT2 inhibitors had a lower risk of CKD development than patients who did not receive SGLT2Is.

"The use of sodium-glucose cotransporter-2 inhibitors is significantly linked with the decrease in the incidence of chronic kidney disease in T2DM with a higher diabetes complications severity index," the authors conclude.

About SGLT2 inhibitors

SGLT2 inhibitors are a class of prescription medication approved by the US FDA for use with exercise and diet to lower blood sugar in adults with type 2 diabetes. Medicines in the SGLT2 inhibitor class include dapagliflozin, canagliflozin, and empagliflozin. Their safety and efficacy have not been established in type 1 diabetes patients and are not approved by the FDA for use in these patients.

Reference:

Chen, TS., Yu, TS., Lin, CL. et al. Role of sodium-glucose cotransporter-2 inhibitors in risk of chronic kidney disease among patients with type 2 diabetes mellitus. J Nephrol (2022). https://doi.org/10.1007/s40620-022-01522-7

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Article Source : Journal of Nephrology

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