SGLT2 inhibitors help protect renal function in geriatric diabetic kidney disease patients

SGLT2 inhibitors offer similar renal protection for patients with diabetic kidney disease (DKD), even those who are over 75 years of age, according to a study.

For the study, researchers used data from the Japan Chronic Kidney Disease Database and applied propensity scores to match patients with DKD aged ≥75 years initiating SGLT2 inhibitors vs other glucose-lowering drugs.

The primary outcome was the decline rate in estimated glomerular filtration rate (eGFR), while the secondary outcomes included a composite of a 40-percent reduction in eGFR or progression to end-stage kidney disease.

The analysis included 348 patients initiating SGLT2 inhibitors and 348 matched patients initiating other glucose-lowering medications. Their mean age was 77.7 years. The mean eGFR at baseline was 59.3 mL/min/1.73m², with proteinuria identified in 230 (33.0 percent) patients.

Throughout the follow-up period, the mean annual rate of eGFR change was significantly smaller with SGLT2 inhibitors than with other glucose-lowering drugs (−0.80 vs −1.78 mL/min/1.73 m²/year; difference, 0.99 mL/min/1.73 m²/year, 95 percent confidence interval [CI], 0.5–1.38; p<0.001).

Composite renal outcomes were documented in 38 patients on SGLT2 inhibitors and in 57 on other glucose-lowering medications (hazard ratio, 0.64, 95 percent CI, 0.42‒0.97).

No evidence of an interaction was observed between SGLT2 inhibitors initiation and proteinuria.