Abstract: FR-PO384
Real-World Analysis of SGLT2 Inhibitors to Prevent Cardiovascular and Kidney Outcomes in Patients with CKD: A Population-Based Cohort Study
Session Information
- Hypertension, CVD, and the Kidneys: Epidemiology
October 25, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Hypertension and CVD
- 1602 Hypertension and CVD: Clinical
Authors
- Toro, Luis, Universidad de Chile Facultad de Medicina, Santiago, Chile
- Valderrama, Josefa, Universidad de Chile Facultad de Medicina, Santiago, Chile
- Polanco, Diego, Universidad de Chile Facultad de Medicina, Santiago, Chile
Group or Team Name
- NephroChile Initiative.
Background
Randomized clinical trials have shown significant benefits of sodium-glucose cotransporter-2 inhibitors (SGLT2i) in chronic kidney disease (CKD). However, there is little data of real-world effects in this population. The objective of this study was to evaluate the effect in preventing clinical outcomes of SGLT2i in CKD patients, in a real-world population-based cohort.
Methods
Observational cohort study of patients > 18 years with CKD (eGFR 20-45 mL/min/1.7m2 or eGFR 45-90 mL/min/1.7m2 with uACR > 200 mg/g) with RAAS blockage, between January 2021 and April 2024. We included patients with and without type 2 diabetes. We performed propensity score matching at a 1:2 ratio. Clinical outcomes were progression of CKD or death from CV causes, reduction of eGFR, development of ESRD, and death from any cause.
Results
We analyzed 3,036 patients, 1,012 SGLT2i users, and 2,024 non-SGLT2 users. Age: 64.5 ± 11.7 years. Female: 1,254 (41.3%). Diabetes: 1,621 (53.3%). eGFR > 45 mL/min/1.7m2: 1,134 (37.3%). eGFR 30-45 mL/min/1.7m2: 1,621 (53.3%). eGFR < 30 mL/min/1.7m2: 281 (9,2%). No baseline differences were present after propensity score matching. Median follow-up: 2.8 years. Patients with SGLT2i had a lower reduction of eGFR than those without SGLT2i (-2.90 ± 0.32 vs. -4.75 ± 0.21 mL/min/1.7m2 per year; p<0.001. Figure 1). Patients with SGLT2i had a lower rate of progression of CKD or death from CV causes (13.9% vs. 19.2%, p<0.001). Multivariate analysis indicated that SGLT2i use was independently associated with reduced adverse clinical outcomes (hazard ratio: 0.71 [0.56-0.88], p<0.001).
Conclusion
Our results indicate that SGLT2 inhibitors have renal and cardiovascular protective effects in real-world conditions. These results support the implementation of current guidelines in clinical practice to improve clinical outcomes in CKD patients.
Study supported by FONDECYT Regular 1221571.
Funding
- Government Support – Non-U.S.