Blood pressure after treatment with sodium–glucose cotransporter 2 inhibitors influences renal composite outcome: Analysis using propensity score‐matched models. Issue 1 (10th July 2020)

• Record Type: Journal Article
• Authors: Kobayashi, Kazuo; Toyoda, Masao; Hatori, Nobuo; Furuki, Takayuki; Sakai, Hiroyuki; Umezono, Tomoya; Ito, Shun; Suzuki, Daisuke; Takeda, Hiroshi; Minagawa, Fuyuki; Degawa, Hisakazu; Yamamoto, Hareaki; Machimura, Hideo; Chin, Keiichi; Hishiki, Toshimasa; Takihata, Masahiro; Aoyama, Kouta; Umezawa, Shinichi; Minamisawa, Kohsuke; Aoyama, Togo; Hamada, Yoshiro; Suzuki, Yoshiro; Hayashi, Masahiro; Hatori, Yutaka; Sato, Kazuyoshi; Miyakawa, Masaaki; Tamura, Kouichi; Kanamori, Akira
• Is Part Of: Journal of diabetes investigation. Volume 12:Issue 1(2021)
• Page Start: 74
• Page End: 81
• Publication Date: 2020-07-10
• Subjects: Blood pressure -- Diabetic nephropathy -- Sodium–glucose cotransporter 2 Inhibitors; Diabetes -- Periodicals; Diabetes -- Research -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462005
• DOI: 10.1111/jdi.13318
• Languages: English
• ISSNs: 2040-1116

Abstract

Abstract: Aims/Introduction: Sodium–glucose cotransporter 2 inhibitors (SGLT2i) improve renal outcome in patients with type 2 diabetes mellitus, but the mechanism is not fully understood. The aim of this retrospective study was to assess the association of achieved blood pressure with renal outcomes in Japanese type 2 diabetes mellitus patients with chronic kidney disease. Materials and Methods: We assessed 624 Japanese type 2 diabetes mellitus patients with chronic kidney disease taking SGLT2i for >1 year. The patients were classified as those with post‐treatment mean arterial pressure (MAP) of ≥92 mmHg ( n = 344) and those with MAP of <92 mmHg ( n = 280) for propensity score matching (1:1 nearest neighbor match with 0.04 of caliper value and no replacement). The end‐point was a composite of progression of albuminuria or a decrease in the estimated glomerular filtration rate by ≥15% per year. Results: By propensity score matching, a matched cohort model was constructed, including 201 patients in each group. The incidence of renal composite outcome was significantly lower among patients with MAP of <92 mmHg than among patients with MAP of ≥92 mmHg ( n = 11 [6%] vs n = 26 [13%], respectively, P = 0.001). The change in estimated glomerular filtration rate was similar in the two groups; however, the change in the albumin‐to‐creatinine ratio was significantly larger in patients with MAP of <92 mmHg. Conclusions: In Japanese type 2 diabetes mellitus patients with chronic kidney disease, blood pressure after SGLT2i administration influences the renal composite outcome. Blood pressure management is important, even during treatment with SGLT2i. Abstract : Incidence of renal composite outcome and changes in logarithmic value of the albumin‐to‐creatinine ratio and estimated glomerular filtration rate.