ABSTRACT
Background:
The
association between the
administration of
sodium-
glucose cotransporter 2 inhibitors (SGLT2is) during
acute kidney injury (AKI) and the
incidence of major adverse
kidney events (MAKEs) is not known.
Methods:
This retrospective
cohort study included
patients with AKI and compared the outcomes for those
who were treated with SGLT2is during
hospitalization and those without SGLT2i
treatment. The
associations of SGLT2i use with MAKEs
at 10 and 30-90 days, each individual MAKE component, and the pre-specified
patient subgroups were analyzed.
Results:
From 2021 to 2023, 374
patients were included in the study-316 without SGLT2i use and 58 with SGLT2i use.
Patients who were treated with SGLT2is were older; had a greater
prevalence of diabetes,
hypertension, chronic
heart failure, and
chronic kidney disease; required
hemodialysis less often; and presented stage 3 AKI less frequently than those
who were not treated with SGLT2is.
Logistic regression analysis with nearest-neighbor matching revealed that SGLT2i use was not associated with the
risk of MAKE10 (OR 1.08 [0.45-2.56]) or with MAKE30-90 (OR 0.76 [0.42-1.36]). For
death, the stepwise approach demonstrated that SGLT2i use was associated with a reduced
risk (OR 0.08; 0.01-0.64), and no effect was found for
kidney replacement therapy (KRT). The subgroups of
patients who experienced a reduction in the
risk of MAKEs in
patients with AKI treated with SGLT2is were those older than 61 years, those with an eGFR >81, and those without a
history of
hypertension or DM (p ≤ 0.05 for all).
Conclusion:
The use of SGLT2is during AKI had no effect on short- or medium-term MAKEs, but some subgroups of
patients may have experienced benefits from SGLT2i
treatment.