Kidney Week

Abstract: TH-PO1014

SGLT2 Inhibitors and Mortality Risk in Individuals with Advanced CKD

Session Information

• CKD: Epidemiology, Risk Factors, and Prevention - 1
  October 24, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Issa, Rochell, Cleveland Clinic, Cleveland, Ohio, United States

Rochell Issa, MD

• Dobre, Mirela A., University Hospitals, Cleveland, Ohio, United States

Mirela A. Dobre, MD, FASN, MPH

• Makhlouf, Mohamed, University Hospitals, Cleveland, Ohio, United States

Mohamed Makhlouf, MD

• Negrea, Lavinia Aura, University Hospitals, Cleveland, Ohio, United States

Lavinia Aura Negrea, MD, FASN

• Brateanu, Andrei, Cleveland Clinic, Cleveland, Ohio, United States

Andrei Brateanu, MD

Background

Sodium-glucose cotransporter-2 inhibitors (SGLT2i) have been shown to reduce all-cause mortality in type 2 diabetes. It is unknown whether this beneficial effect is maintained in advanced CKD stages 4-5D, irrespective of diabetes status.

Methods

In this retrospective cohort study of electronic health records from the TriNetX Analytics Network, we aimed to assess the associations of SGLT2i with all-cause mortality compared to usual care without SGLT2i medications in patients >65 years with CKD 4-5D. The hazard ratios (HRs) and 95% confidence intervals (CIs) of all cause mortality were calculated for the 6-month, 1 and 5 year follow-up by comparing propensity score-matched patient groups.

Results

The study population included 40,000 patients with CKD stages 4-5D who were prescribed SGLT2i or usual care without SGLT2i. Compared with non-SGLT2i users, patients with CKD 4 or 5 pre-dialysis (mean age 74.8± 6.2 years, 48% female), or CKD 5D (mean age 73.3±5.8 years, 42% female) taking SGLT2i had lower risk for all-cause mortality, consistent across CKD stages and time points (Table).

Conclusion

The use of SGLT2i was associated with a significant lower all-cause mortality risk in patients with advanced CKD stages 4, 5, or 5D.

Mortality risk at 6 months, 1 year, and 5 years by CKD stage in SGLT2i users (+) vs non-users (-)

Funding

• Other NIH Support