Retrospective analysis of effects of sodium-glucose co-transporter 2 inhibitor in Japanese type 2 diabetes mellitus patients with chronic kidney disease.

Abstract

AIM:

The aim of this study was to assess the renal effects of the glucose-lowering SGLT2 inhibitors in Japanese type 2 diabetes mellitus patients with chronic kidney disease.

METHODS:

The Kanagawa Physicians Association maintains a registry of patients who visit their 31 clinics. Clinical data of type 2 diabetes mellitus patients with chronic kidney disease, who were prescribed SGLT2 inhibitors in addition to other treatments, were collected and analysed.

RESULTS:

SGLT2i was associated with a fall in HbA1c from 64.1 ± 16.7 mmol/mol (8.0 ± 1.5%) to 56.5 ± 12.9 mmol/mol (7.3 ± 1.2%) ( p < 0.01) in 869 analysed cases, a decrease in urine albumin-creatinine ratio from a median of 47.1 to 41.1 mg/gCr, and decrease in estimated glomerular filtration rate from 77.7 ± 23.9 to 75.0 ± 23.9 mL/min/1.73 m2 ( p < 0.01). The effect on albumin-creatinine ratio was independent of age or stage of estimated glomerular filtration; however, there was a significant negative correlation between albumin-creatinine ratio at the initiation of SGLT2 inhibitor and change in ACR. Multiple linear regression analysis identified use of empagliflozin, β-blockers, and sulphonylureas, Δsystolic blood pressure at office, serum Cr and albumin-creatinine ratio value at initiation of SGLT2 inhibitor as independent and significant determinants of change in ACR.

CONCLUSIONS:

This study confirmed that the beneficial renal effects of SGLT2 inhibitor in Japanese type 2 diabetes mellitus patients with chronic kidney disease, similar to those reported in large-scale clinical trials conducted in Western countries.

• Authors: Kazuo Kobayashi, Masao Toyoda, Moritsugu Kimura, Nobuo Hatori, Takayuki Furuki, Hiroyuki Sakai, Masahiro Takihata, Tomoya Umezono, Shun Ito, Daisuke Suzuki, Hiroshi Takeda, Akira Kanamori, Hisakazu Degawa, Hareaki Yamamoto, Hideo Machimura, Atsuko Mokubo, Keiichi Chin, Mitsuo Obana, Toshimasa Hishiki, Kouta Aoyama, Shinichi Nakajima, Shinichi Umezawa, Hidetoshi Shimura, Togo Aoyama, Kazuyoshi Sato, Masaaki Miyakawa
• Journal: Diabetes & vascular disease research (Diab Vasc Dis Res) Vol. 16 Issue 1 Pg. 103-107 (01 2019) ISSN: 1752-8984 [Electronic] England
• PMID: 30284913 (Publication Type: Journal Article, Observational Study)

Chemical References

• Biomarkers
• Glycated Hemoglobin A
• Sodium-Glucose Transporter 2 Inhibitors
• hemoglobin A1c protein, human
• Creatinine

Topics

• Aged
• Albuminuria (epidemiology, physiopathology)
• Biomarkers (blood, urine)
• Creatinine (urine)
• Diabetes Mellitus, Type 2 (blood, diagnosis, drug therapy, epidemiology)
• Diabetic Nephropathies (diagnosis, epidemiology, physiopathology, urine)
• Female
• Glomerular Filtration Rate (drug effects)
• Glycated Hemoglobin (metabolism)
• Humans
• Japan (epidemiology)
• Kidney (drug effects, physiopathology)
• Male
• Middle Aged
• Registries
• Renal Insufficiency, Chronic (diagnosis, epidemiology, physiopathology, urine)
• Retrospective Studies
• Sodium-Glucose Transporter 2 Inhibitors (adverse effects, therapeutic use)
• Time Factors
• Treatment Outcome