Open AccessSodium–glucose cotransporter 2 inhibitors in type 2 diabetes patients with renal function impairment slow the annual renal function decline, in a real clinical practice
Author(s) -
Hirai Taro,
Kitada Munehiro,
Monno Itaru,
Oda Erina,
Hayashi Yoshihiro,
Shimada Keiji,
Takagaki Yuta,
Ogura Yoshio,
Fujii Mizue,
Konishi Kazunori,
Sakurai Masaru,
Nakagawa Atsushi,
Koya Daisuke
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.13502
Subject(s) - medicine , renal function , albuminuria , diabetes mellitus , urology , type 2 diabetes , type 2 diabetes mellitus , endocrinology
Aims/Introduction The aim of this study was to elucidate whether sodium–glucose cotransporter 2 inhibitors (SGLT2is) treatment has any renoprotective effect for type 2 diabetes mellitus patients with an estimated glomerular filtration rate (eGFR) of <60 mL/min/1.73 m 2 in clinical practice. Materials and Methods We evaluated the annual eGFR slope in 85 type 2 diabetes mellitus patients with renal impairment, treated with SGLT2is ≥2 years. Each patient's eGFR was <60 mL/min/1.73 m 2 at the start of SGLT2is therapy. The calculation of the annual change in eGFR for each patient was obtained by acquired eGFR data before and after 2 years of the initial SGLT2is administration, followed by analysis of the changes in the mean eGFR slope. Results The participants' mean age was 72.0 ± 9.4 years, and the mean eGFR was 47.1 ± 9.7 mL/min/1.73 m 2 at the start of additional treatment with SGLT2is. The mean annual eGFR slope after SGLT2is administration (−0.11 ± 0.20 mL/min/1.73 m 2 /year) was significantly slower than before SGLT2is administration (−2.93 ± 0.59 mL/min/1.73 m 2 /year; P < 0.0001). Additionally, SGLT2is treatment slowed the annual decline of eGFR, independent of the levels of both the initial eGFR and albuminuria levels before SGLT2is therapy was started. In the patient groups who showed an annual eGFR decline of ≥3 and 1–3 mL/min/1.73 m 2 , there was a significant slowing of the decline after SGLT2is therapy, compared with before the treatment ( P < 0.001, respectively). Conclusions SGLT2is administration slows the decline observed in the annual renal function in type 2 diabetes mellitus patients with eGFR of <60 mL/min/1.73 m 2 in clinical practice.