Effects of SGLT2 inhibitors across the spectrum of albuminuria in cardiovascular-kidney-metabolic conditions: A pooled analysis of randomised trials
Abstract
Background: Albuminuria is associated with an increased risk of cardiovascular and kidney events. Sodium glucose co-transporter 2 inhibitors (SGLT2i) reduce albuminuria and improve kidney outcomes in patients with albuminuric chronic kidney disease (CKD). Patients with low- or without albuminuria have been underrepresented in randomised clinical trials (RCTs), and the effects of SGLT2i on cardiovascular and kidney outcomes across the full range of albuminuria require further investigation.
Aims: To study the effects of SGLT2i on kidney and cardiovascular outcomes across albuminuria levels in populations with different cardiovascular-kidney-metabolic (CKM) risk.
Methods: Individual-patient data pooled analysis of RCTs across the CKM spectrum. Outcomes were studied across urinary albumin-to-creatinine ratio (UACR) both as categorical and continuous variables using survival and mixed effects models.
Results: A total of 26 750 patients were included. The median (pct25-75) baseline UACR was 28 (8-240) mg/g: 13 669 (51.1%) had UACR 300 mg/g. Compared to patients with lower UACR, those with higher UACR were younger, with a more frequent history of hypertension, diabetes, and obesity, and lower eGFR. UACR was linearly associated with kidney and cardiovascular outcomes as well as mortality. Compared to placebo, SGLT2i reduced the risk of kidney events, HF hospitalisations, atherothrombotic events, cardiovascular and all-cause mortality across the full UACR spectrum (Pinteraction >0.1…
How strong is the evidence?
Evidence Hub reads this as a secondary / pooled analysis, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 26 participants or records.
Read the paper
Related studies
- Risk Factors for Coronavirus Disease 2019 (COVID-19) Death in a Population Cohort Study from the Western Cape Province, South Africa
- Global and regional estimates of genital human papillomavirus prevalence among men: a systematic review and meta-analysis
- A methodology for assessing deployment trauma and its consequences in OEF/OIF/OND veterans: The TRACTS longitudinal prospective cohort study
- Post‑COVID‑19 Syndrome in Outpatients: a Cohort Study
- Factors Influencing Primary and Secondary Implant Stability—A Retrospective Cohort Study with 582 Implants in 272 Patients
- Electroacupuncture for Painful Diabetic Peripheral Neuropathy: A Multicenter, Randomized, Assessor-Blinded, Controlled Trial
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.