SGLT2 Inhibitors Reduce the Risk of Renal Failure in CKD Stage 5 Patients with Type 2 DM

Sodium-glucose cotransporter-2 (SGLT2) inhibitors have emerged as a promising therapy for diabetes and CKD patients. However, the pros and cons of SGLT2i in Type2 diabetes patients with CKD stage 5 remained largely unexplored. By using Taiwan's national health insurance research database (NHIRD), this observational cohort study enrolled T2DM patients with newly identified as having CKD5, and the index date defined as the date of CKD5 identification. The enrollees were divided into 2 groups depending on whether SGLT2 inhibitors were used for more than 3 months or not following the index date. A 1:4 propensity score matching was performed to balance characteristics between two groups. The SGLT2-inhibitor group exhibited significantly lower risks of new-onset ESRD (35.9% vs. 58.2%, hazard ratio [HR] 0.59, 95% confidence interval [CI]: 0.59-0.74). For the risks of MACCEs (16.72% vs. 17.66%, HR 0.84, 95% CI: 0.62-1.15), infections related hospitalization (2.4% vs. 2.61%, HR:1.02, 95% CI:0.80-1.31), Infection-associated mortality (3.45% vs. 4.18% HR:0.80, 95% CI:0.41-1.56) and all-cause mortality (13.79% vs. 13.83%, HR:0.95, 95% CI:0.68-1.32), no significant differences were observed between two groups. In conclusion, we provide evidence suggesting that SGLT2 inhibitors may offer renal protection and did not increase infection risks for CKD5 patients with type2 diabetes.