Kidney Week

Abstract: SA-PO0532

Real-World Effect of SGLT2 Inhibitors on CKD Stage Transitions in Taiwan

Session Information

• CKD: Clinical - Therapies, CKM Health, Special Populations, and More
  October 24, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2202 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

• Lin, Ming-Yen, Kaohsiung Medical University Chung Ho Memorial Hospital, Kaohsiung, Kaohsiung City, Taiwan

Ming-Yen Lin, PhD

• Liu, Jia-sin, Kaohsiung Medical University, Kaohsiung, Kaohsiung City, Taiwan

Jia-sin Liu, MS

• Yang, Lii-Jia, Kaohsiung Medical University Chung Ho Memorial Hospital, Kaohsiung, Kaohsiung City, Taiwan

Lii-Jia Yang, MD

• Chung, Cheng-Yin, Kaohsiung Medical University Chung Ho Memorial Hospital, Kaohsiung, Kaohsiung City, Taiwan

Cheng-Yin Chung, MD

• Wu, Ping-Hsun, Kaohsiung Medical University Chung Ho Memorial Hospital, Kaohsiung, Kaohsiung City, Taiwan

Ping-Hsun Wu, MD, PhD

• Hwang, Shang-Jyh, Kaohsiung Medical University Chung Ho Memorial Hospital, Kaohsiung, Kaohsiung City, Taiwan

Shang-Jyh Hwang, MD

• Chiu, Yi-Wen, Kaohsiung Medical University, Kaohsiung, Kaohsiung City, Taiwan

Yi-Wen Chiu, MD

Group or Team Name

• the iH3 Research Group

Background

Effects of sodium–glucose cotransporter 2 (SGLT2) inhibitors on longitudinal CKD stage transitions in real-world populations remain insufficiently characterized. We aimed to evaluate the associations between SGLT2 inhibitor use and CKD stage transitions, dialysis, and mortality using nationwide CKD care program databases in Taiwan.

Methods

Patients with CKD enrolled in Taiwan's nationwide early CKD and pre-ESRD care programs between 2012 and 2021 were included. Participants underwent routine monitoring at least every 3 months, enabling longitudinal assessment of CKD stage transitions. We evaluated transitions among 18 CKD stages, as well as transitions to dialysis and death. SGLT2 inhibitor exposure was defined by reimbursed prescription codes within 1 year before the index date of each originating CKD stage. Cox proportional hazards models were applied to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for each CKD stage transition, dialysis, and death. Statistically significant associations (P<0.05) are highlighted.

Results

A total of 1.1 million patients contributing 3.7 million CKD care visits were analyzed. Median follow-up was 385 days. Across originating CKD stages, adjusted HRs for dialysis associated with SGLT2 inhibitor use ranged from 0.31 (95% CI 0.28–0.35) to 0.79 (95% CI 0.67–0.94). Similar protective associations were observed for mortality (HR range 0.30–0.77). In earlier CKD stages (up to G3aA3), SGLT2 inhibitor use was generally associated with lower hazards of progression to more advanced CKD stages. In contrast, among patients with more advanced CKD stages, several transitions toward less severe CKD stages were observed.

Conclusion

In this nationwide CKD cohort, SGLT2 inhibitor use was consistently associated with lower hazards of dialysis and mortality across CKD stages. However, heterogeneous associations with CKD stage transitions in advanced CKD suggest potential differences in treatment juncture, warranting further investigation.

Acknowledgment

This work was mainly supported by the National Health Research Institutes, Taiwan [grant number: NHRI-EX115-11208PI].

Fig. 1. Adjusted Hazard Ratios for CKD Stage Transitions, Dialysis, and Mortality Associated With SGLT2 Inhibitor Use.