Scientific Poster Session III - Original Research

Original Research
  Monday, October 14, 2024
  01:00 PM–02:30 PM

Abstract

Introduction: Sodium-glucose cotransporter 2 inhibitors (SGLT2is) have been shown to benefit individuals with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD) in randomized controlled trials. However, it remains unclear whether initiating SGLT2 inhibitors (SGLT2is) in patients with moderate to advanced CKD can slow CKD progression in real-world settings.

Research Question or Hypothesis: This study aims to evaluate the renal outcomes in CKD patients following the use of SGLT2is.

Study Design: Retrospective cohort study

Methods: The retrospective cohort study recruited data from nephrology clinics at Taipei Tzu Chi Hospital in Taiwan. Patients with CKD stage 3-5, who were prescribed canagliflozin or dapagliflozin between 1^st January, 2020 and 28^th February, 2023, were included. We excluded patients with less than 84 days with SGLT2i prescription, less than two eGFR data after first SGLT2i treatment, kidney transplant, hemodialysis, or unreasonable eGFR value. The primary outcome was the CKD deterioration ratio, defined as progression of CKD stage, reduction over 25% in eGFR level, and end-stage renal disease (ESRD). We also compared the treatment effect between different eGFR intervals and patients with or without T2DM.

Results: There were 215 patients with canagliflozin or dapagliflozin use during inclusion period. After the exclusion criteria, 95 patients were included for data analysis. The decline from the first to the fourth recorded eGFR value was 39.3 mL/min/1.73m² and 37.7 mL/min/1.73m² (N=90, P-value=0.147). CKD deterioration was observed in 20 patients (21.1%), and ESRD occurred in two individuals (2.1%). Subgroup analysis showed significant CKD worsening in patients with an eGFR between 15-30 mL/min/1.73m² compared to those with an eGFR between 30-<45 mL/min/1.73m² (P-value<0.05). There was no significant CKD deterioration between T2DM and non-T2DM patients.

Conclusion: Our study demonstrates that SGLT2is are beneficial for slowing CKD progression and reducing the risk of ESRD in individuals with moderate to advanced CKD. The effect may diminish as worsening of renal function.

Presenting Author

Yi-Ju Chen Master's degree
Taipei Tzu Chi Hospital

Authors

Yi-Hsien Hsiao Bachelor degree
Taipei Tzu Chi Hospital

Yi-Chun Kuo Bachelor degree
Taipei Tzu Chi Hospital

Jun-Yang Lin Bachelor degree
Taipei Tzu Chi Hospital

Yi-Chin Lin Bachelor degree
Taipei Tzu Chi Hospital

Tzu-Rong Peng Master's degree
Taipei Tzu Chi Hospital