Open AccessBlood pressure after treatment with sodium–glucose cotransporter 2 inhibitors influences renal composite outcome: Analysis using propensity score‐matched models
Author(s) -
Kobayashi Kazuo,
Toyoda Masao,
Hatori Nobuo,
Furuki Takayuki,
Sakai Hiroyuki,
Umezono Tomoya,
Ito Shun,
Suzuki Daisuke,
Takeda Hiroshi,
Minagawa Fuyuki,
Degawa Hisakazu,
Yamamoto Hareaki,
Machimura Hideo,
Chin Keiichi,
Hishiki Toshimasa,
Takihata Masahiro,
Aoyama Kouta,
Umezawa Shinichi,
Minamisawa Kohsuke,
Aoyama Togo,
Hamada Yoshiro,
Suzuki Yoshiro,
Hayashi Masahiro,
Hatori Yutaka,
Sato Kazuyoshi,
Miyakawa Masaaki,
Tamura Kouichi,
Kanamori Akira
Publication year - 2021
Publication title -
journal of diabetes investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.089
H-Index - 50
eISSN - 2040-1124
pISSN - 2040-1116
DOI - 10.1111/jdi.13318
Subject(s) - medicine , renal function , albuminuria , kidney disease , diabetes mellitus , blood pressure , propensity score matching , type 2 diabetes , creatinine , type 2 diabetes mellitus , urology , surgery , endocrinology
Aims/Introduction Sodium–glucose cotransporter 2 inhibitors (SGLT2i) improve renal outcome in patients with type 2 diabetes mellitus, but the mechanism is not fully understood. The aim of this retrospective study was to assess the association of achieved blood pressure with renal outcomes in Japanese type 2 diabetes mellitus patients with chronic kidney disease. Materials and Methods We assessed 624 Japanese type 2 diabetes mellitus patients with chronic kidney disease taking SGLT2i for >1 year. The patients were classified as those with post‐treatment mean arterial pressure (MAP) of ≥92 mmHg ( n = 344) and those with MAP of <92 mmHg ( n = 280) for propensity score matching (1:1 nearest neighbor match with 0.04 of caliper value and no replacement). The end‐point was a composite of progression of albuminuria or a decrease in the estimated glomerular filtration rate by ≥15% per year. Results By propensity score matching, a matched cohort model was constructed, including 201 patients in each group. The incidence of renal composite outcome was significantly lower among patients with MAP of <92 mmHg than among patients with MAP of ≥92 mmHg ( n = 11 [6%] vs n = 26 [13%], respectively, P = 0.001). The change in estimated glomerular filtration rate was similar in the two groups; however, the change in the albumin‐to‐creatinine ratio was significantly larger in patients with MAP of <92 mmHg. Conclusions In Japanese type 2 diabetes mellitus patients with chronic kidney disease, blood pressure after SGLT2i administration influences the renal composite outcome. Blood pressure management is important, even during treatment with SGLT2i.