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Abstract: FR-PO902

Nephrologist Use of Sodium-Glucose Cotransporter-2 (SGLT2) Inhibitors Relative to Other Specialties, 2015-2022

Session Information

Category: CKD (Non-Dialysis)

  • 2201 CKD (Non-Dialysis): Epidemiology‚ Risk Factors‚ and Prevention


  • Adhikari, Rishav, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
  • Jha, Kunal, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
  • Blaha, Michael J., Johns Hopkins University School of Medicine, Baltimore, Maryland, United States

Multiple clinical trials have demonstrated that sodium-glucose cotransporter-2 inhibitors (SGLT2is) slow progression of kidney disease and reduce cardiorenal mortality in patients with chronic kidney disease (CKD). Clinical guidelines recommend these medications for most patients with CKD, but few receive them. In this study, we characterized trends in SGLT2i use by nephrologists compared to other physicians.


We analyzed near-census level data from IQVIA’s National Prescription Audit. This audit collects prescription dispensing activity from 93% of U.S. outpatient pharmacies and then projects that data to estimate 100% of prescriptions. We quantified monthly SGLT2i prescriptions from January 2015-April 2022, stratified by prescriber specialty and molecule. We also used physician census data from the AMA Physician Masterfile to calculate prescriptions per physician.


From January 2015 - April 2022, monthly prescriptions of SGLT2is by nephrologists increased 35-fold (from 884 to 31,192) (Fig 1) while monthly prescriptions across all specialties increased 4-fold (from 447,915 to 1,807,389). However, nephrologists accounted for only 1.26% of all prescriptions in the final 12 months of the study. Although nephrologists outnumber them by ≈50%, endocrinologists accounted for 11-fold more prescriptions during that period. On a per-physician basis, nephrologists accounted for 21 prescriptions per physician in the final 12 months, while endocrinologists, primary-care physicians, and cardiologists accounted for 316, 33, and 18, respectively. Nephrologists predominantly used dapagliflozin, which was less frequently used by non-nephrologists (52% vs 28% of prescriptions). Notable accelerations in SGLT2i use and shifts in drug choice by nephrologists coincided with the CREDENCE trial, DAPA-CKD trial, and expansion of dapagliflozin’s FDA label.


Nephrologists have markedly increased use of SGLT2is over the past 7 years, with surges in uptake coinciding with favorable renal outcomes data, but continue to account for a small proportion of overall prescriptions.