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Kidney Week

Abstract: SA-PO454

Impact of SGLT2 Inhibitor on All-Cause Mortality Among Patients with Type 2 Diabetes with and Without CKD

Session Information

Category: Diabetic Kidney Disease

  • 702 Diabetic Kidney Disease: Clinical

Authors

  • Almuhaiteeb, Abdullah, Amiri Hospital, Kuwait City, Kuwait, Kuwait
  • Abu-Farha, Mohamed, Dasman Diabetes Institute, Kuwait City, Kuwait
  • Abubaker, Jehad, Dasman Diabetes Institute, Kuwait City, Kuwait
  • Ali, Hamad, Dasman Diabetes Institute, Kuwait City, Kuwait
  • Al-Mulla, Fahd, Dasman Diabetes Institute, Kuwait City, Kuwait
Background


SGLT2 inhibitors have been shown to improve survival among patients with chronic kidney disease (CKD) with and without diabetes. The long-term mortality benefit remains unclear. In addition, the existence of CKD among type 2 diabetes mellitus (DM) who are on SLGT-2 inhibitor can influence its mortality benefit. In this study, we wanted to compare mortality benefit among type 2 DM who are taking SGLT2 inhibitors and CKD to patients with normal renal function. We hypothesize that SGLT2 inhibitor should be started prior to the development of renal impairment among patients with type 2 DM.

Methods

In this retrospective study, we included all type 2 diabetes patients who presented to Dasman Diabetes institute for follow up from 2015 until 2022. The patients were divided based upon whether they were taking SGLT2- inhibitor or not and their CKD status. The main outcome was all-cause mortality.

Results

A total of 3569 patients were included. The all-cause mortality unadjusted hazard ratio (HR) for patients who were on SGLT2-inihbitor was 0.61 (95% CI, 0.41-0.89). After Adjusting for AgeGroup, gender, BMI and CKD stage, the adjusted HR ratio was 0.67 (95% CI, 0.45-0.99). The all-cause mortality HR for patients who were on SGLT2- inhibitor was 0.64 (95% CI, 0.43-0.95) which was adjusted for renal impairment. The HR for patients who had renal impairment who did not receive SGLT2 inhibitor was 4.41 (95% CI, 2.94-6.608). Whereas for patients who were on SGLT2 inhibitor and had renal impairment the adjusted HR was 2.82 (95% CI, 1.60-4.99) and 2.37 (95% CI, 1.31-4.27).

Conclusion

Over period of 8 years follow up, SGLT2-inhbitors were associated with lower all-cause mortality. The presence of CKD is associated with reduced survival suggesting that SGLT2 inhibitor should be started prior to the development of renal disease to improve survival. More research required to assess the optimal time to start SGLT2 inhibitor.