Kidney Week

Abstract: TH-PO1055

Caffeine Effects on eGFR Dip in Patients Who Started SGLT2 Inhibitors

Session Information

• CKD Progression and Complications: Diagnosis, Prognosis, Risk Factors
  November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

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

Authors

• Kisley, Zach, Saint Louis University School of Medicine, Saint Louis, Missouri, United States

Zach Kisley,

• Edwards, John C., Saint Louis University School of Medicine, Saint Louis, Missouri, United States

John C. Edwards,

• Dhindsa, Sandeep Singh Dhindsa, Saint Louis University School of Medicine, Saint Louis, Missouri, United States

Sandeep Singh Dhindsa Dhindsa,

• Lentine, Krista L., Saint Louis University School of Medicine, Saint Louis, Missouri, United States

Krista L. Lentine,

• Mosman, Amy, Saint Louis University School of Medicine, Saint Louis, Missouri, United States

Amy Mosman,

• Kalishman, Amanda Jordan, Saint Louis University School of Medicine, Saint Louis, Missouri, United States

Amanda Jordan Kalishman,

• Memon, Aliza Anwar, Saint Louis University School of Medicine, Saint Louis, Missouri, United States

Aliza Anwar Memon,

• Kunnath, Paul, Saint Louis University School of Medicine, Saint Louis, Missouri, United States

Paul Kunnath,

• Wood, Emily, Saint Louis University School of Medicine, Saint Louis, Missouri, United States

Emily Wood,

• Miyata, Kana N., Saint Louis University School of Medicine, Saint Louis, Missouri, United States

Kana N. Miyata,

Background

Sodium-glucose cotransporter-2 inhibitors (SGLT2i) have widespread effects including antihyperglycemia, renoprotection, and cardioprotection. Renoprotection is thought to be mainly mediated by a reduction in glomerular filtration rate (GFR) via tubuloglomerular feedback (TGF), which is referred to as the GFR “dip”. Adenosine plays an important role in signal transmission in the TGF mechanism and caffeine is a nonselective adenosine receptor antagonist. We hypothesized that patients with high caffeine intake have reduced eGFR dip after starting SGLT2i compared to patients with no or small caffeine intake.

Methods

This is a retrospective cohort study conducted at Saint Louis University. Caffeine consumption was collected via survey. Retrospective chart review was performed to trend creatinine before and 1-2 months after the initiation of SGLT2i. Inclusion criteria included adult patients receiving SGLT2i regardless of indication (diabetes mellitus, heart failure, or chronic kidney disease) and eGFR ≥30 ml/min/1.73 m² at the time of initiation. Student’s t test was used to analyze differences of eGFR change (% change from the baseline) between patients with high caffeine intake and low caffeine intake. Pearson’s correlation coefficient was used to analyze correlation between caffeine intake and eGFR change.

Results

The survey was collected from 36 patients (N=13 on Dapagliflozin, N=22 on Empagliflozin, and N=1 on Ertugliflozin). The mean age of the study cohort was 62.9±11.1 years old and 58.3% were female. The median eGFR at SGLT2i initiation was 50 ml/min/1.73 m². Top quartile caffeine takers (≥400 mg/day, N=9) had significantly lower % eGFR dip compared to the low caffeine takers (<400mg/day, N=27); 0.46±12.51 % vs 11.83±14.45%, respectively (p<0.05). In a subgroup analysis of those who were not on loop diuretics, which could affect TGF, % eGFR dip was inversely correlated with the caffeine intake (N=24, r=-0.55, p<0.01).

Conclusion

Our study shows that caffeine consumed at high levels (above 400mg daily) can mitigate the eGFR dip after SGLT2i initiation. Further study is needed to assess its long-term effects on SGLT2i’s renoprotective property.

Funding

• Private Foundation Support