Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Sep 6;11(18):5259.
doi: 10.3390/jcm11185259.

Sodium-Glucose Cotransporter-2 Inhibitors Could Help Delay Renal Impairment in Patients with Type 2 Diabetes: A Real-World Clinical Setting

Gyunam Park  1 , Byungha Choi  1   2 , Soyoung Kang  1   3 , Bomin Kim  1 , Min Jung Chang  1   2   3
Affiliations

Sodium-Glucose Cotransporter-2 Inhibitors Could Help Delay Renal Impairment in Patients with Type 2 Diabetes: A Real-World Clinical Setting

Gyunam Park et al. J Clin Med. .

Abstract

This study compared the renoprotective effects of sodium−glucose cotransporter-2 (SGLT2) inhibitors and dipeptidyl peptidase-4 (DPP-4) inhibitors in patients with type 2 diabetes mellitus (T2DM). We performed a retrospective cohort study using electronic medical records of patients with T2DM. The primary outcome was the first occurrence of an estimated glomerular filtration rate (eGFR) <45 mL/min/1.73 m2 after the index date. We analyzed changes in repeatedly measured laboratory data, such as eGFR and serum uric acid (SUA). We included 2396 patients (1198 patients in each group) in the present study. The rate of renal events was significantly lower in the SGLT2 inhibitors group than that in the DPP-4 inhibitors group (hazard ratio, 0.46; 95% CI, 0.29 to 0.72; p = 0.0007). The annual mean change in the eGFR was significantly smaller in the SGLT2 inhibitors group than that in the DPP-4 inhibitors group, with a between-group difference of 0.86 ± 0.18 mL/min/1.73 m2 per year (95% CI, 0.49 to 1.23; p < 0.0001). Moreover, the mean change in SUA was lower in the SGLT2 inhibitors group. Considering the lower incidence of renal impairment, the slower decline in eGFR, and reduced SUA, SGLT2 inhibitors could help delay renal impairment in patients with T2DM.

Keywords: antidiabetic drug; diabetic kidney disease (DKD); renoprotective effect; sodium–glucose cotransporter-2 (SGLT2) inhibitor.

PubMed Disclaimer

Conflict of interest statement

We report no potential conflict of interest in this study.

Figures

Figure 1
Figure 1
Flowchart of patient inclusion and exclusion. CKD, chronic kidney disease; DPP-4 dipeptidyl peptidase-4; eGFR, estimated glomerular filtration rate; ESRD, end-stage renal disease; HbA1c, glycated hemoglobin; SCr, serum creatinine; SGLT2, sodium–glucose cotransporter-2; UACR, urine–albumin–creatinine ratio.
Figure 2
Figure 2
Comparison of cumulative incidence of renal events (eGFR < 45 mL/min/1.73 m2) in matched cohort between SGLT2 inhibitors group and DPP-4 inhibitors group. eGFR, estimated glomerular filtration rate; SGLT2, sodium–glucose cotransporter-2; DPP-4, dipeptidyl peptidase-4.
Figure 3
Figure 3
Change in eGFR in the SGLT2 inhibitors group and DPP-4 inhibitors group. Error bars indicate standard error. The numbers below the graph refer to the number of patients at each time point. eGFR, estimated glomerular filtration rate; SGLT2, sodium–glucose cotransporter-2; DPP-4, dipeptidyl peptidase-4.
See this image and copyright information in PMC

References

    1. Khan M.A.B., Hashim M.J., King J.K., Govender R.D., Mustafa H., Al Kaabi J. Epidemiology of Type 2 Diabetes—Global Burden of Disease and Forecasted Trends. J. Epidemiol. Glob. Health. 2020;10:107–111. doi: 10.2991/jegh.k.191028.001. - DOI - PMC - PubMed
    1. Saeedi P., Petersohn I., Salpea P., Malanda B., Karuranga S., Unwin N., Colagiuri S., Guariguata L., Motala A.A., Ogurtsova K., et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9(th) edition. Diabetes Res. Clin. Pract. 2019;157:107843. doi: 10.1016/j.diabres.2019.107843. - DOI - PubMed
    1. Fu H., Liu S., Bastacky S.I., Wang X., Tian X.J., Zhou D. Diabetic kidney diseases revisited: A new perspective for a new era. Mol. Metab. 2019;30:250–263. doi: 10.1016/j.molmet.2019.10.005. - DOI - PMC - PubMed
    1. Selby N.M., Taal M.W. An updated overview of diabetic nephropathy: Diagnosis, prognosis, treatment goals and latest guidelines. Diabetes Obes. Metab. 2020;22((Suppl. S1)):3–15. doi: 10.1111/dom.14007. - DOI - PubMed
    1. Lozano-Maneiro L., Puente-Garcia A. Renin-Angiotensin-Aldosterone System Blockade in Diabetic Nephropathy. Present Evidences. J. Clin. Med. 2015;4:1908–1937. doi: 10.3390/jcm4111908. - DOI - PMC - PubMed