Original Research ARTICLE
Renal and Glucose-lowering Effects of Empagliflozin and Dapagliflozin In Different Chronic Kidney Disease Stages
- 1Linkou Chang Gung Memorial Hospital, Taiwan
Objective The objective of this study was to investigate the effects of sodium-glucose cotransporter 2 (SGLT2) inhibitors on renal function in different stages of chronic kidney disease (CKD).
Design and Methods We conducted a retrospective cohort study using longitudinal claims data from May 2016 – December 2017 from the Chang Gung Research Database. Patients who used one of the three types of SGLT2 inhibitor available at Chang Gung Memorial Hospital, namely empagliflozin 10mg/tab (Empa10), empagliflozin 25mg/tab (Empa25), and dapagliflozin 10mg/tab (Dapa), were included, with the same number of matched non-users. Analysis of variance was used for continuous variables and the chi‐square test was applied for categorical variables. Differences in data between two groups were analyzed using an independent t-test, and the basic data before and after treatment were analyzed using generalized estimating equation (GEE). The association among renal function changes was analyzed using a Cox proportional hazards model, with the results presented as unadjusted hazard ratios (HRs) with 95% confidence intervals (95% CIs).
Results Among the 7624 SGLT2 inhibitor users, 1696 patients used Empa10, 2654 used Empa25, and 3274 used Dapa. Compared with non-users, dapagliflozin had the lowest risk of estimated glomerular filtration rate (eGFR) decrease over 40% from baseline within 1 year (HR 0.36, 95% CI 0.25−0.51). By using the ICD-10-CM code N179, the acute kidney injury (AKI)-related hospitalization rate was lower in Empa10 and Dapa users than in non-users (HR 0.65, 95% CI 0.49−0.86).
Conclusion Lower risk of eGFR decrease over 40% and AKI-related hospitalization was found in all SGLT2 inhibitor users across the different CKD stages.
Keywords: sodium–glucose cotransporter 2 inhibitors, Renal function, Acute Kidney Injury, Chang Gung Research Database, sugar control
Received: 14 Jun 2019;
Accepted: 08 Nov 2019.
Copyright: © 2019 Lin, Huang, Hsieh, Sun, Chen and Lin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Prof. Chia-Hung Lin, Linkou Chang Gung Memorial Hospital, Linkou, Taiwan, email@example.com