Retrospective analysis of effects of sodium-glucose co-transporter 2 inhibitor in Japanese type 2 diabetes mellitus patients with chronic kidney disease. (January 2019)

• Record Type: Journal Article
• Authors: Kobayashi, Kazuo; Toyoda, Masao; Kimura, Moritsugu; Hatori, Nobuo; Furuki, Takayuki; Sakai, Hiroyuki; Takihata, Masahiro; Umezono, Tomoya; Ito, Shun; Suzuki, Daisuke; Takeda, Hiroshi; Kanamori, Akira; Degawa, Hisakazu; Yamamoto, Hareaki; Machimura, Hideo; Mokubo, Atsuko; Chin, Keiichi; Obana, Mitsuo; Hishiki, Toshimasa; Aoyama, Kouta; Nakajima, Shinichi; Umezawa, Shinichi; Shimura, Hidetoshi; Aoyama, Togo; Sato, Kazuyoshi; Miyakawa, Masaaki
• Is Part Of: Diabetes & vascular disease research. Volume 16:Number 1(2019:Jan.)
• Page Start: 103
• Page End: 107
• Publication Date: 2019-01
• Subjects: Sodium-glucose co-transporter 2 inhibitor -- urine albumin-creatinine ratio -- chronic kidney disease -- retrospective study; Diabetic angiopathies -- Periodicals; 616.462005
• DOI: 10.1177/1479164118802759
• Languages: English
• ISSNs: 1479-1641

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 m 2 ( 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.