Abstract: SA-PO1083
SGLT2 Inhibitor Use in Patients on Hemodialysis: Safety Profile and Clinical Outcomes in Real-World Practice
Session Information
- Kidney Replacement Therapy and Care Delivery Innovations
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Martinez Vaquera, Shaira, Diaverum Spain, Renal Services, Madrid, Spain
- Molina, Sonia Caparros, Diaverum Spain, Renal Services, Madrid, Spain
- Useche Bonilla, Gustavo Andres, Diaverum Spain, Renal Services, Madrid, Spain
Background
Sodium-glucose cotransporter-2 inhibitors (SGLT2i) provide cardiovascular and renal benefits in non-dialysis chronic kidney disease, but their role in maintenance hemodialysis (HD) remains uncertain because dialysis patients were excluded from pivotal trials. We evaluated the association of SGLT2i use with hospitalization, mortality, and laboratory parameters in HD patients in real-world clinical practice.
Methods
Multicenter retrospective observational study including adult HD patients treated with SGLT2i for at least 3 months. Propensity score matching (3:1) was performed to reduce indication bias using demographic and clinical variables, including age, sex, Charlson comorbidity index, functional status, diabetes, hypertension, ischemic heart disease, heart failure, and antidiabetic treatment. Sensitivity analysis was performed using inverse probability of treatment weighting (IPTW). Hospitalizations were analyzed using Andersen-Gill models for recurrent events and mortality using Cox regression.
Results
A total of 436 patients were analyzed, including 109 treated with SGLT2i and 327 matched controls. No significant differences were observed in all-cause or cardiovascular hospitalization rates between groups. Higher hospitalization burden was independently associated with greater comorbidity. Mortality rates were also similar between treated and control patients during follow-up. Patients receiving SGLT2i showed higher normalized protein catabolic rate (nPCR) and lower ferritin levels compared with controls.
Conclusion
In this multicenter real-world HD cohort, SGLT2i use was not associated with increased hospitalization or mortality over 18 months of follow-up, supporting a favorable safety profile in dialysis patients. Observed differences in laboratory parameters may suggest biological effects beyond glycemic control. These findings support the need for prospective studies evaluating the role of SGLT2i in maintenance HD populations traditionally excluded from clinical trials.