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Kidney Week

Abstract: TH-PO1044

Validation of Impact Using SGLT2 Inhibitor in Changes of Body Weight and Serum Albumin for Elderly Patients with CKD: A Retrospective Observational Study

Session Information

Category: CKD (Non-Dialysis)

  • 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

  • Honjoh, Honami, Tokyo Ika Daigaku, Shinjuku-ku, Tokyo, Japan
  • Moriyama, Takahito, Tokyo Ika Daigaku, Shinjuku-ku, Tokyo, Japan
Background

Elderly Chronic Kidney Disease (CKD) patients have a high frequency of frailty. These definitions include body weight (BW) loss and decreasing serum albumin, perceived as critical changes suspecting nutrition disorder. Although recent studies have shown that Sodium-glucose cotransporter 2 inhibitors (SGLT2Is) have improved renal surviva, the impact of SGLT2Is on nutrition status in elderly CKD patients is not well understood.

Methods

This retrospective observational study was conducted on CKD patients who were treated with SGLT2I at our department from 2020 to 2023. From these 207 patients, 94 patients whose serum creatinine (Cr), serum albumin, and BW had been fully measured at the three time points (baseline and at one year before and after treatment) were included. eGFR slopes and the % change of serum alb and BW were calculated from a one-year period before baseline and a one-year period after treatment, respectively.

Results

The characteristics of 94 patients) were mean age 65.1±15.6 (≥65 years old: 58.5%), female 21 (22.3%), diabetes 37 (39.4%), hypertension 86 (91.5%), ischemic heart disease 19 (14.7%), mean eGFR 40.9±23.1 mL/min/1.73 m 2 . Overall, eGFR slope was not changed between before and after treatment (before treatment -0.173 mL/min/1.73m2/month, after treatment -0.22 mL/min/1.73m 2 /month, p=0.83). % BW was significantly decreased after administration [-0.0 (-0.28 to 2.1) %/year vs -2.0 (-0.43 to 0.0) %/year, p < 0.001], though serum albumin was not changed (p=0.13). Elderly pstients had more severe CKD, lower BMI, more frequent ischemic heart disease, less use of inhibitors of renin angiotensin-aldosterone systems, and lower baseline eGFR compared with not elderly patients. In high-risk group , which had the decreasing changes in both % BW and % albumin between before and after treatment, the eGFR was significantly lower (p=0.016). The predictors for BW loss and decreasing serum alb were baseline lower albumin level [odd ratio (OR) 7.22 (1.17- 44.7), p = 0.033 and more severe CKD stage 2.44 (1.05-5.67), p = 0.037].

Conclusion

It was suggested that the lower the serum albumin level and the more severe CKD stage, the more likely BW and serum albumin will decrease in this study. Further evaluation is required to determine whether these changes are associated with malnutrition.