Kidney Week

Abstract: SA-OR031

Extending Benefit to the Oldest Old: Efficacy of SGLT2 Inhibitors in Older Adults with CKD

Session Information

• CKD in Overlooked Populations
  October 24, 2026 | Location: Mile High Ballroom 1A, Convention Center
  Abstract Time: 05:00 PM - 05:10 PM

Category: Geriatric Nephrology

• 1300 Geriatric Nephrology

Authors

• Doricic, Julian, Medizinische Hochschule Hannover, Hanover, NDS, Germany

Julian Doricic, DrMed

• Willerding, Jonas Michael, Medizinische Hochschule Hannover, Hanover, NDS, Germany

Jonas Michael Willerding

• Melk, Anette, Medizinische Hochschule Hannover, Hanover, NDS, Germany

Anette Melk, MD, PhD

• Schmidt-Ott, Kai M., Medizinische Hochschule Hannover, Hanover, NDS, Germany

Kai M. Schmidt-Ott, MD, FASN

• Greite, Robert, Medizinische Hochschule Hannover, Hanover, NDS, Germany

Robert Greite, MD

• Gwinner, Wilfried, Medizinische Hochschule Hannover, Hanover, NDS, Germany

Wilfried Gwinner, MD

• Schmidt, Bernhard M.W., Medizinische Hochschule Hannover, Hanover, NDS, Germany

Bernhard M.W. Schmidt, MD, MS

Background

Prevalence of chronic kidney disease (CKD) is growing and aging has been identified as a major factor. Sodium-glucose cotransporter-2 inhibitors (SGLT2i) have become well established as a treatment for patients with CKD. Elderly patients over 80 years of age with CKD have been rarely studied and were underrepresented in previous large-scale trials. The effects of SGLT2i therapy in this specific cohort are understudied.

Methods

In a retrospective cohort study utilizing the TriNetX database, we investigated in a first-use design the implementation of SGLT2i in patients over 80 years of age with CKD. As the primary endpoint, all-cause mortality was investigated. Secondary endpoints focused on major adverse cardiovascular events (MACE) and major adverse kidney events (MAKE). Cox proportional hazards models were used to estimate hazard ratios with 95% confidence intervals and results were considered as adjusted hazard ratios (aHR), as previous propensity score matching had been performed. The Kaplan-Meier curves represented time-to-event analyses with censoring at the time of the last documented patient visit.

Results

After propensity score matching for comorbidities, laboratory parameters, and frailty-associated factors, the group of SGLT2i users and the group of non-users both consisted of 23,765 patients. After a two-year follow-up, a significant reduction in mortality was observed among patients treated with SGLT2i (aHR 0.734; 95% CI 0.705 – 0.765, p<0 .0001). In addition, the SGLT2i cohort demonstrated benefits regarding MACE (aHR 0.884; 95%CI 0.857-0.913, p<0.0001) and MAKE (aHR 0.775; 95%CI 0.745-0.806, p<0.0001). Across all predefined subgroups, SGLT2i treatment was consistently associated with a lower risk of mortality.

Conclusion

Even the oldest CKD patients benefit from SGLT2i treatment, which was associated with a reduced risk of mortality as well as improved cardiovascular and renal outcomes.