Residents and Fellows Research in Progress
Sunday, November 12, 2023
12:45 PM–02:15 PM
Abstract
Introduction: Sodium-glucose cotransporter-2 (SGLT2) inhibitors are recommended for first-line management of type 2 diabetes in patients with comorbid chronic kidney disease (CKD). Expansion of SGLT2 inhibitor use in patients with late-stage CKD prompts the need for a pragmatic evaluation of the efficacy and safety of SGLT2 inhibitor continuation in patients with type 2 diabetes and progression of CKD to stages 4 and 5.
Research Question or Hypothesis: Patients with type 2 diabetes and late-stage CKD who are continued on an SGLT2 inhibitor will experience improved efficacy and similar safety profiles compared to those who discontinued SGLT2 inhibitor use.
Study Design: Retrospective cohort study
Methods: Adult patients with type 2 diabetes and late-stage CKD prescribed an SGLT2 inhibitor between 06/01/2018 and 06/01/2023 will be included. Late-stage kidney disease is defined as patients with an estimated glomerular filtration rate of less than 45 ml per minute per 1.73 m2 of body-surface area calculated via the CKD-EPI equation, including those patients requiring dialysis or with a history of renal transplantation. Endpoints will be compared between patients who continued an SGLT2 inhibitor to date versus those who discontinued therapy. The primary endpoint is change from baseline in HbA1c. Secondary endpoints include change from baseline in weight as well as safety endpoints including the occurrence of mycotic or urinary tract infections, acute kidney injury, dehydration, and ketoacidosis. Univariate analyses will be used to identify relevant differences in patient characteristics between the cohorts for inclusion into multivariate analyses (p<0.1). Linear regression and multivariate logistic regressions will be used to evaluate the primary and secondary endpoints for continuous and dichotomous outcomes. Results will be presented as an odds ratio with p<0.05 considered statistically significant. Institutional review board approval is in progress.
Results: In-progress
Conclusion: In-progress
Presenting Author
Olivia Denny Pharm.D.University at Buffalo School of Pharmacy and Pharmaceutical Sciences
Authors
Nicole Albanese Pharm.D., CDCES, BCACP
University at Buffalo
Calvin Meaney PharmD, BCPS
University at Buffalo School of Pharmacy and Pharmaceutical Sciences
Scott Monte Pharm.D.
University at Buffalo, School of Pharmacy and Pharmaceutical Sciences
Nicholas Norgard PharmD
University of Missouri Kansasy City School of Medicine
Nicole Siwarski Pharm.D. Candidate
University at Buffalo School of Pharmacy and Pharmaceutical Sciences