Abstract: FR-OR50
Improvement in Anemia by SGLT2 Inhibitors Were More Prominent Among Those with Inflammation
Session Information
- Interventions to Reduce CKD Progression
November 03, 2023 | Location: Room 119, Pennsylvania Convention Center
Abstract Time: 05:51 PM - 06:00 PM
Category: Anemia and Iron Metabolism
- 200 Anemia and Iron Metabolism
Authors
- Murashima, Miho, Nagoya Shiritsu Daigaku, Nagoya, Aichi, Japan
- Kasugai, Takahisa, Nagoya Shiritsu Daigaku, Nagoya, Aichi, Japan
- Tomonari, Tatsuya, Nagoya Shiritsu Daigaku, Nagoya, Aichi, Japan
- Ono, Minamo, Nagoya Shiritsu Daigaku, Nagoya, Aichi, Japan
- Mizuno, Masashi, Nagoya Shiritsu Daigaku, Nagoya, Aichi, Japan
- Hamano, Takayuki, Nagoya Shiritsu Daigaku, Nagoya, Aichi, Japan
Background
SGLT2 inhibitors (SGLT2i) were reported to increase hemoglobin (Hb) by suppressing hepcidin and increasing erythropoietin, similar to hypoxia-inducible factor prolyl hydroxylase (HIF-PH) inhibitors. We hypothesized that an increase in Hb by SGLT2i might be more prominent among patients with inflammation similar to HIF-PH inhibitors.
Methods
In this retrospective cohort study, diabetic outpatients from 2019 to 2020 at our hospital were enrolled. Exposure was the use of SGLT2i. The Hb slope within 6 months after initiation of SGLT2i (the first 6 months of the observation period for non-users) was analyzed using a mixed-effects model. Non-linear regression models were fitted with restricted cubic splines to investigate Hb levels at the last visit across different eGFR levels. Analyses were performed separately for those with higher and lower than the median baseline C-reactive protein (CRP) levels. The data were adjusted for potential confounders.
Results
Among 1,246 patients, 306 were on SGLT2i. During the first 6 months, CRP and eGFR trajectories were not significantly different between users and non-users of SGLT2i. Differences in Hb slope between users and non-users of SGLT2i were 0.14 (0.05–0.24) and 0.05 (-0.05–0.15) g/dL/month for those with higher and lower baseline CRP, respectively, after adjustment for confounders including time-dependent eGFR. Hb levels at the last visit were significantly higher among SGLT2i users across the range of eGFR levels, and it was more prominent among those with higher CRP (p for interaction<0.1).
Conclusion
SGLT2i use was associated with higher Hb levels, especially among those with inflammation across the range of eGFR levels. The results suggest that SGLT2i could improve anemia among patients with anemia of chronic kidney disease and inflammation which are refractory to treatment with erythropoiesis-stimulating agents.