Aim: To examine the renal effects of sodium-glucose cotransporter-2 (SGLT2) inhibition among non-diabetic individuals with chronic kidney disease (CKD) in a real-world setting.
Methods: The study collected de-identified data on adults without diabetes and with an estimated glomerular filtration rate (eGFR) of 25-60 mL/min/1.73 m2, who initiated the SGLT2 inhibitors dapagliflozin or empagliflozin between September 2020 and November 2022. The effects of SGLT2 inhibitors on renal function were assessed by changes in eGFR slope over time. The annual baseline slope was calculated using eGFR measurements during the 2 years prior to the index date, while the annual follow-up slope was calculated from evaluations during 90-900 days post index date.
Results: Among the 354 participants with CKD, without diabetes, who received SGLT2 inhibitors and were followed for a median of 527 days, the mean age was 72.8 ± 11.8 years, 26% were female, and 91% used renin-angiotensin system blockade. The mean eGFR was 45.4 ± 9.5 mL/min/1.73 m2, and the mean body mass index was 29.1 ± 5.4 kg/m2. The study found that the mean eGFR slope over time improved from -5.6 ± 7.7 mL/min/1.73 m2 per year at baseline to -1.7 ± 6.8 mL/min/1.73 m2 per year after SGLT2 inhibitor administration (p <0.001), indicating a significant improvement in renal function. This effect was observed to be independent of the urinary albumin to creatinine ratio (UACR).