Abstract: PO2393
Prescribing Patterns of Sodium-Glucose Cotransporter 2 Inhibitors in Patients with CKD
Session Information
- CKD: Qualitative and Quantitative Observational Studies
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2102 CKD (Non-Dialysis): Clinical, Outcomes, and Trials
Authors
- Zhuo, Min, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States
- Li, Jiahua, Brigham and Women's Hospital Department of Medicine, Boston, Massachusetts, United States
- Mount, David B., Brigham and Women's Hospital Department of Medicine, Boston, Massachusetts, United States
- Steele, David J. R., Massachusetts General Hospital, Boston, Massachusetts, United States
- Lucier, David J., Massachusetts General Hospital, Boston, Massachusetts, United States
- Mendu, Mallika L., Brigham and Women's Hospital Department of Medicine, Boston, Massachusetts, United States
Background
Since the publication of the EMPA-REG trial in 2015, sodium-glucose cotransporter-2 inhibitors (SGLT-2i) have been demonstrated to slow chronic kidney disease (CKD) progression in patients with diabetic kidney disease (DKD). More recently in October 2010, the DAPA-CKD trial demonstrated SGLT-2i slows CKD progression regardless of diabetes (DM) status. We evaluated the adoption of these novel therapeutics in CKD patients, without and with DM.
Methods
A cross-sectional study of the Mass General Brigham Health System CKD registry was conducted in March 2021. All adult patients with non-dialysis CKD stages 3-5 were included. Multivariable logistic regression models were used to assess factors associated with SGLT-2i use in patients without and with DM.
Results
Among 49,587 non-DM, CKD patients, only 145 (0.3%) were taking SGLT-2i. Of 22,653 DM, CKD patients, 1,442 (6.4%) were taking SGLT-2i. As shown in the Figure, younger age, Male sex, Black race, history of heart failure, and cardiologist visit in the past year were associated with higher rates of SGLT-2i use in both cohorts. In patients with DM, nephrologist visit in the past year was associated with a higher rate of SGLT-2i use, whereas advanced CKD stages were associated with lower rates of SGLT-2i use.
Conclusion
Despite a well-demonstrated benefit of SGLT-2i, the adaption of these novel agents remained extremely low in the CKD population, particularly among patients without DM. Given the approval of SGLT-2i for CKD in May 2021, interventions to increase SGLT-2i usage and improve outcomes in patients with CKD are urgently needed.