PMID- 35756732
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220716
IS  - 2048-8505 (Print)
IS  - 2048-8513 (Electronic)
IS  - 2048-8505 (Linking)
VI  - 15
IP  - 7
DP  - 2022 Jul
TI  - A real-world study on SGLT2 inhibitors and diabetic kidney disease progression.
PG  - 1403-1414
LID - 10.1093/ckj/sfac044 [doi]
AB  - BACKGROUND: Randomized controlled trials have demonstrated the benefits of 
      sodium-glucose cotransporter 2 inhibitors (SGLT2is) in people with type 2 
      diabetes mellitus (T2DM) and chronic kidney disease (CKD). However, real-world 
      data on CKD progression and the development of end-stage kidney disease (ESKD) 
      remains scarce. Our aim was to study renal outcomes of people with diabetic 
      kidney disease (DKD) using SGLT2is in a highly prevalent DKD population. METHODS: 
      Between 2016 and 2019 we recruited T2DM patients in the renal and diabetic 
      clinics in a regional hospital in Singapore. Patients prescribed SGLT2is were 
      compared with those on standard anti-diabetic and renoprotective treatment. The 
      outcome measures were CKD progression [a >/=25% decrease from baseline and 
      worsening of estimated glomerular filtration rate (eGFR) categories according to 
      the Kidney Disease: Improving Global Outcomes guidelines] and ESKD (eGFR <15 
      mL/min/1.73 m(2)). RESULTS: We analysed a total of 4446 subjects; 1598 were on 
      SGLT2is. There was a significant reduction in CKD progression hazard ratio [HR] 
      0.60 [95% confidence interval (CI) 0.49-0.74] with SGLT2is. The HR for 
      eGFR >/=45 mL/min/1.73 m(2) and 15-44 mL/min/1.73 m(2) was 0.60 (95% CI 0.47-0.76) 
      and 0.43 (95% CI 0.23-0.66), respectively. There was also a reduction in risk for 
      developing ESKD for the entire cohort [HR 0.33 (95% CI 0.17-0.65)] and eGFR 15-44 
      mL/min/1.73 m(2) [HR 0.24 (95% CI 0.09-0.66)]. Compared with canagliflozin and 
      dapagliflozin, empagliflozin showed a sustained risk reduction of renal outcomes 
      across CKD stages 1-4. CONCLUSIONS: This real-world study demonstrates the 
      benefits of SGLT2is on CKD progression and ESKD. The effect is more pronounced in 
      moderate to advanced CKD patients.
CI  - (c) The Author(s) 2022. Published by Oxford University Press on behalf of the ERA.
FAU - Liu, Allen Yan Lun
AU  - Liu AYL
AUID- ORCID: 0000-0002-4615-5548
AD  - Department of General Medicine, Khoo Teck Puat Hospital, Singapore.
FAU - Low, Serena
AU  - Low S
AD  - Clinical Research Unit, Khoo Teck Puat Hospital, Singapore.
FAU - Yeoh, Ester
AU  - Yeoh E
AD  - Diabetes Centre, Admiralty Medical Centre, Kampung Admiralty, Singapore.
FAU - Lim, Eng Kuang
AU  - Lim EK
AD  - Department of General Medicine, Khoo Teck Puat Hospital, Singapore.
FAU - Renaud, Claude Jeffrey
AU  - Renaud CJ
AD  - Department of General Medicine, Khoo Teck Puat Hospital, Singapore.
FAU - Teoh, Selene Tse Yen
AU  - Teoh STY
AD  - Department of General Medicine, Khoo Teck Puat Hospital, Singapore.
FAU - Tan, Grace Feng Ling
AU  - Tan GFL
AD  - Department of General Medicine, Khoo Teck Puat Hospital, Singapore.
FAU - Chai, Chung Cheen
AU  - Chai CC
AD  - Department of General Medicine, Khoo Teck Puat Hospital, Singapore.
FAU - Liu, Bo
AU  - Liu B
AD  - Department of General Medicine, Khoo Teck Puat Hospital, Singapore.
FAU - Subramaniam, Tavintharan
AU  - Subramaniam T
AD  - Diabetes Centre, Admiralty Medical Centre, Kampung Admiralty, Singapore.
FAU - Sum, Chee Fang
AU  - Sum CF
AD  - Diabetes Centre, Admiralty Medical Centre, Kampung Admiralty, Singapore.
FAU - Lim, Su Chi
AU  - Lim SC
AUID- ORCID: 0000-0002-3361-7512
AD  - Clinical Research Unit, Khoo Teck Puat Hospital, Singapore.
LA  - eng
PT  - Journal Article
DEP - 20220216
PL  - England
TA  - Clin Kidney J
JT  - Clinical kidney journal
JID - 101579321
PMC - PMC9217649
OTO - NOTNLM
OT  - CKD progression
OT  - ESKD
OT  - SGLT2is
OT  - diabetes mellitus
OT  - diabetic kidney disease
OT  - real-world study
EDAT- 2022/06/28 06:00
MHDA- 2022/06/28 06:01
PMCR- 2022/02/16
CRDT- 2022/06/27 04:10
PHST- 2021/09/07 00:00 [received]
PHST- 2022/06/27 04:10 [entrez]
PHST- 2022/06/28 06:00 [pubmed]
PHST- 2022/06/28 06:01 [medline]
PHST- 2022/02/16 00:00 [pmc-release]
AID - sfac044 [pii]
AID - 10.1093/ckj/sfac044 [doi]
PST - epublish
SO  - Clin Kidney J. 2022 Feb 16;15(7):1403-1414. doi: 10.1093/ckj/sfac044. eCollection 
      2022 Jul.