AUTHOR=Lin Yi-Hsuan , Huang Yu-Yao , Hsieh Sheng-Hwu , Sun Jui-Hung , Chen Szu-Tah , Lin Chia-Hung 

TITLE=Renal and Glucose-Lowering Effects of Empagliflozin and Dapagliflozin in Different Chronic Kidney Disease Stages

JOURNAL=Frontiers in Endocrinology

VOLUME=Volume 10 - 2019

YEAR=2019

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2019.00820

DOI=10.3389/fendo.2019.00820

ISSN=1664-2392

ABSTRACT=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.