Cardiometabolic & kidney

Effect of sodium-glucose cotransporter-2 inhibitors on kidney outcomes of individuals with type 2 diabetes according to blood pressure levels

Eur J Prev CardiolPublished Retrospective cohort study

Authors' conclusion

This nationwide cohort analysis demonstrated that the kidney-protective effect of SGLT2 inhibitors could be modified by baseline SBP

Study context

Population
Individuals newly prescribed SGLT2 or DPP4 inhibitors for T2DM, nationwide epidemiological cohortmatched cohort
Participants
2,148 vs 4,296
Exposure
SGLT2 inhibitors vs DPP4 inhibitors
  • SGLT2 inhibitorn = 2,148
  • DPP4 inhibitorn = 4,296reference
Outcome
Annual eGFR decline
Methodological detailspropensity-score matched (1:2), nationwide
  • Propensity-score matched (1:2)
  • Nationwide

Main finding

As reported in the abstract

SGLT2 inhibitor

−1.32

mL/min/1.73 m²

DPP4 inhibitor

−1.50

mL/min/1.73 m²

Treatment effect of SGLT2 inhibitors over DPP4 inhibitors augmented with higher systolic BP (SBP)
P for interaction = 0.0199

Observational data: associations, not effects.

Further findings

30% or 40% reduction in estimated glomerular filtration rate (eGFR)

Advantages of SGLT2 inhibitors persisted, with a trend of augmented effect with higher SBP

Annual eGFR decline, females with lower SBP (subgroup)

eGFR decline exacerbated with SGLT2 inhibitors vs DPP4 inhibitors

Original publication

Effect of sodium-glucose cotransporter-2 inhibitors on kidney outcomes of individuals with type 2 diabetes according to blood pressure levels. Eur J Prev Cardiol. Published 18 March 2025. doi:10.1093/eurjpc/zwaf156

Summarised from the published abstract; every number is checked against it

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