A Real-World Cohort Study on the Association of the Use of Sodium-Glucose Cotransporter-2 Inhibitor With the Incidence of Chronic Kidney Disease (CKD) in Patients With Type 2 Diabetes Mellitus Without CKD Using the SingHealth Diabetes Registry
Abstract
Background: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are well-established for slowing chronic kidney disease (CKD) progression. However, their role in reducing the incidence of CKD in individuals with diabetes mellitus remains unclear.
Objectives: We evaluate the association of SGLT2i use with CKD incidence in a pre-CKD multi-ethnic Asian population with type 2 diabetes mellitus (T2D) with no CKD.
Materials and methods: This retrospective cohort study analysed patients with T2D from 2016 to 2023 using the SingHealth Diabetes Registry. Patients with baseline estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73 m2 and urinary albumin-to-creatinine ratio (uACR) < 30 mg/g were included. Cases and controls were matched based on age, gender, housing type, body mass index, HbA1c, baseline eGFR, renin-angiotensin-system inhibitors, metformin and glucagon-like peptide-1 receptor agonist using propensity score matching (PSM). Primary outcome was incident CKD and secondary outcomes included eGFR and uACR change over time. We used conditional logistic regression to estimate the odds ratio of incident CKD and mixed-effects linear regression to assess eGFR change over time.
Results: Of 21 780 patients, 4450 patients (2225/group) were analysed after PSM. Median baseline eGFR were 103.58 mL/min/1.73 m2 and 103.53 mL/min/1.73 m2 in SGLT2i users and non-users, respectively. SGLT2i users had lower CKD incidence (OR 0.36, 95% CI 0.31-0.42; p < 0.001) compared to non-users.…
How strong is the evidence?
Evidence Hub reads this as a cohort study, 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: 4,450 participants or records.
Read the paper
Related studies
- Metformin as an adjuvant in breast cancer treatment
- Metformin Lysosomal Targeting: A Novel Aspect to Be Investigated for Metformin Repurposing in Neurodegenerative Diseases?
- Aberrant HSF1 signaling activation underlies metformin amelioration of myocardial infarction in mice
- Metformin induces ZFP36 by mTORC1 inhibition in cervical cancer-derived cell lines
- Protein Interaction Network for Identifying Vascular Response of Metformin (Oral Antidiabetic)
- Preventing Long COVID With Metformin
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.