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SGLT2 inhibitors ‘not linked to kidney injury’

By Editor
7th September 2017

People with type 2 diabetes who take sodium-glucose cotransporter-2 (SGLT2) inhibitors are not at risk of  acute kidney injury (AKI) despite concerns, researchers have said.

The medications have been shown to improve cardiovascular and renal outcomes in those who have type 2 diabetes, however there have been medical alerts relating to the treatment. The Food and Drug Administration (FDA) has warned canagliflozin and dapagliflozin could increase the risk of AKI in people.

It was because of this that a team from the Icahn School of Medicine at Mount Sinai in New York decided to investigate the real-world risk of AKI comparing SGLT2 inhibitor users and people who do not take them.

They collected data from the Mount Sinai chronic kidney disease registry and for 1,207 users and 1,207 non-users in the Geisinger Health System cohort.

The researchers found that over a median follow-up of 14 months, 3.8 per cent and 9.7 per cent of SGLT2 users and nonusers in the Mount Sinai cohort, respectively, had an AKIKDIGO event (hazard ratio [HR], 0.4; 95 per cent confidence interval [CI], 0.2 to 0.7; P =.01).

The HR was unchanged after adjustment (adjusted HR, 0.4; 95 per cent CI, 0.2 to 0.7; P =.004). Within the Geisinger cohort, 2.2 per cent and 4.6 per cent of users and nonusers, respectively, had an AKI KDIGO event. The unadjusted hazards of AKIKDIGO were lower in users (HR, 0.5; 95 per cent CI, 0.3 to 0.8; P <.01); after adjustment for covariates there was modest attenuation (adjusted HR, 0.6; 95 per cent CI, 0.4 to 1.1; P =.09).

The authors concluded: “Our findings do not suggest an increased risk of AKI associated with SGLT2 inhibitor use in patients with type 2 diabetes in two large health systems.”

To read the study, click here.

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