ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2020
Use of sodium-glucose cotransporter-2 inhibitors and risk of acute kidney injury in older adults with diabetes: a population-based cohort study.
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Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 2 of them syntheses that pooled it.
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30citing papers in PubMed, 2 pooled it
8.1field-weighted citation impact, top 2% of its field
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Who cites it
30 citing papers in PubMed, 2 syntheses or guidelines pooled it, 72 citations in OpenAlex.
- Acute kidney injury events in patients with diabetes using sodium glucose transporter 2 inhibitors: a meta-analysis of cohort studies.Acta diabetologica · 2024Pooled it
- Renal effectiveness and safety of the sodium-glucose cotransporter-2 inhibitors: a population-based cohort study.BMJ open diabetes research & care · 2021Pooled it
- Cardiovascular effectiveness and safety of SGLT2 inhibitors vs DPP4 inhibitors by dementia status: a cohort study of older adults with diabetes.Diabetologia · 2026Article
- Sodium-glucose cotransporter-2 inhibitors beyond glycemic control: Their role in acute kidney injury recovery.World journal of nephrology · 2025Review
- Association between sodium-glucose co-transporter-2 inhibitors and cardiac outcomes in cancer patients: a systematic review and meta-analysis.Journal of geriatric cardiology : JGC · 2025Article
- The Protective Effects of SGLT-2 Inhibitors Against Postoperative Acute Kidney Injury in Type 2 Diabetes.Kidney international reports · 2025Article
- Continuation Versus Discontinuation of Sodium-Glucose Cotransporter-2 Inhibitors and Cardiorenal Outcomes Among Patients With Type 2 Diabetes and Chronic Kidney Disease: A Nationwide Cohort Study With a Target Trial Emulation Framework.Clinical and translational science · 2025Article
- Sodium-glucose co-transporter 2 inhibitors: Prospects for canine myxomatous mitral valve disease and finding the "right drug" and the "right dose" for dogs.The Journal of veterinary medical science · 2025Review
- Comparators in Pharmacovigilance: A Quasi-Quantification Bias Analysis.Drug safety · 2024Article
- A cohort study of sodium-glucose cotransporter-2 inhibitors after acute kidney injury among Veterans with diabetic kidney disease.Kidney international · 2024Article
- The association between sodium glucose cotransporter-2 inhibitors vs dipeptidyl peptidase-4 inhibitors and renal outcomes in people discharged from hospital with type 2 diabetes: A population-based cohort study.Journal of diabetes · 2024Article
- Renal Oxygen Demand and Nephron Function: Is Glucose a Friend or Foe?International journal of molecular sciences · 2023Review
- Novel glucose-lowering drugs and the risk of acute kidney injury in routine care; the Stockholm CREAtinine Measurements (SCREAM) project.Journal of nephrology · 2023Observational
- Acute kidney injury in diabetes mellitus: Epidemiology, diagnostic, and therapeutic concepts.FASEB journal : official publication of the Federation of American Societies for Experimental Biology · 2023Review
- Value of SGLT-2 inhibitors in the treatment of chronic kidney disease : Clinical and practical implications.Wiener klinische Wochenschrift · 2023Review
- Emerging Role of Sodium-Glucose Co-Transporter 2 Inhibitors for the Treatment of Chronic Kidney Disease.International journal of nephrology and renovascular disease · 2023Review
- Article
- Physicians' Considerations and Practice Recommendations Regarding the Use of Sodium-Glucose Cotransporter-2 Inhibitors.Journal of clinical medicine · 2022Review
- Prescribing SGLT2 Inhibitors in Patients With CKD: Expanding Indications and Practical Considerations.Kidney international reports · 2022Review
- SGLT2 Inhibition in Type 1 Diabetes with Diabetic Kidney Disease: Potential Cardiorenal Benefits Can Outweigh Preventable Risk of Diabetic Ketoacidosis.Current diabetes reports · 2022Review
Corrections and comments
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Authors and funding
14 authors at 1 institution in 2 countries.
Carina IskanderDepartments of Epidemiology and Biostatistics (Iskander, Clemens, Dixon, Jeyakumar, Muanda, Garg), and Medicine (Clemens, Garg), Western University, London, Ont.; Department of Medicine, Division of Nephrology (Cherney), Toronto General Hospital, University of Toronto; Department of Physiology, and Banting and Best Diabetes Centre (Cherney), University of Toronto; Division of Nephrology (Harel, Wald), St. Michael's Hospital; Faculty of Medicine (Udell), University of Toronto; Cardiovascular Division (Udell), Department of Medicine and Women's College Research Institute, Women's College Hospital, Toronto, Ont.; Toronto, Ont.; ICES (Clemens, Dixon, Jeyakumar, McArthur, Muanda, Paterson, Garg), London, Ont.; Division of Nephrology (Parikh), School of Medicine, Johns Hopkins University, Baltimore, Md.; Department of Internal Medicine (Tangri), Max Rady College of Medicine, University of Manitoba; Seven Oaks General Hospital (Tangri), Chronic Disease Innovation Centre, Winnipeg, Man. carina.iskander@ices.on.ca.
David Z CherneyDepartments of Epidemiology and Biostatistics (Iskander, Clemens, Dixon, Jeyakumar, Muanda, Garg), and Medicine (Clemens, Garg), Western University, London, Ont.; Department of Medicine, Division of Nephrology (Cherney), Toronto General Hospital, University of Toronto; Department of Physiology, and Banting and Best Diabetes Centre (Cherney), University of Toronto; Division of Nephrology (Harel, Wald), St. Michael's Hospital; Faculty of Medicine (Udell), University of Toronto; Cardiovascular Division (Udell), Department of Medicine and Women's College Research Institute, Women's College Hospital, Toronto, Ont.; Toronto, Ont.; ICES (Clemens, Dixon, Jeyakumar, McArthur, Muanda, Paterson, Garg), London, Ont.; Division of Nephrology (Parikh), School of Medicine, Johns Hopkins University, Baltimore, Md.; Department of Internal Medicine (Tangri), Max Rady College of Medicine, University of Manitoba; Seven Oaks General Hospital (Tangri), Chronic Disease Innovation Centre, Winnipeg, Man.
Kristin K ClemensDepartments of Epidemiology and Biostatistics (Iskander, Clemens, Dixon, Jeyakumar, Muanda, Garg), and Medicine (Clemens, Garg), Western University, London, Ont.; Department of Medicine, Division of Nephrology (Cherney), Toronto General Hospital, University of Toronto; Department of Physiology, and Banting and Best Diabetes Centre (Cherney), University of Toronto; Division of Nephrology (Harel, Wald), St. Michael's Hospital; Faculty of Medicine (Udell), University of Toronto; Cardiovascular Division (Udell), Department of Medicine and Women's College Research Institute, Women's College Hospital, Toronto, Ont.; Toronto, Ont.; ICES (Clemens, Dixon, Jeyakumar, McArthur, Muanda, Paterson, Garg), London, Ont.; Division of Nephrology (Parikh), School of Medicine, Johns Hopkins University, Baltimore, Md.; Department of Internal Medicine (Tangri), Max Rady College of Medicine, University of Manitoba; Seven Oaks General Hospital (Tangri), Chronic Disease Innovation Centre, Winnipeg, Man.
Stephanie N DixonDepartments of Epidemiology and Biostatistics (Iskander, Clemens, Dixon, Jeyakumar, Muanda, Garg), and Medicine (Clemens, Garg), Western University, London, Ont.; Department of Medicine, Division of Nephrology (Cherney), Toronto General Hospital, University of Toronto; Department of Physiology, and Banting and Best Diabetes Centre (Cherney), University of Toronto; Division of Nephrology (Harel, Wald), St. Michael's Hospital; Faculty of Medicine (Udell), University of Toronto; Cardiovascular Division (Udell), Department of Medicine and Women's College Research Institute, Women's College Hospital, Toronto, Ont.; Toronto, Ont.; ICES (Clemens, Dixon, Jeyakumar, McArthur, Muanda, Paterson, Garg), London, Ont.; Division of Nephrology (Parikh), School of Medicine, Johns Hopkins University, Baltimore, Md.; Department of Internal Medicine (Tangri), Max Rady College of Medicine, University of Manitoba; Seven Oaks General Hospital (Tangri), Chronic Disease Innovation Centre, Winnipeg, Man.
Ziv HarelDepartments of Epidemiology and Biostatistics (Iskander, Clemens, Dixon, Jeyakumar, Muanda, Garg), and Medicine (Clemens, Garg), Western University, London, Ont.; Department of Medicine, Division of Nephrology (Cherney), Toronto General Hospital, University of Toronto; Department of Physiology, and Banting and Best Diabetes Centre (Cherney), University of Toronto; Division of Nephrology (Harel, Wald), St. Michael's Hospital; Faculty of Medicine (Udell), University of Toronto; Cardiovascular Division (Udell), Department of Medicine and Women's College Research Institute, Women's College Hospital, Toronto, Ont.; Toronto, Ont.; ICES (Clemens, Dixon, Jeyakumar, McArthur, Muanda, Paterson, Garg), London, Ont.; Division of Nephrology (Parikh), School of Medicine, Johns Hopkins University, Baltimore, Md.; Department of Internal Medicine (Tangri), Max Rady College of Medicine, University of Manitoba; Seven Oaks General Hospital (Tangri), Chronic Disease Innovation Centre, Winnipeg, Man.
Nivethika JeyakumarDepartments of Epidemiology and Biostatistics (Iskander, Clemens, Dixon, Jeyakumar, Muanda, Garg), and Medicine (Clemens, Garg), Western University, London, Ont.; Department of Medicine, Division of Nephrology (Cherney), Toronto General Hospital, University of Toronto; Department of Physiology, and Banting and Best Diabetes Centre (Cherney), University of Toronto; Division of Nephrology (Harel, Wald), St. Michael's Hospital; Faculty of Medicine (Udell), University of Toronto; Cardiovascular Division (Udell), Department of Medicine and Women's College Research Institute, Women's College Hospital, Toronto, Ont.; Toronto, Ont.; ICES (Clemens, Dixon, Jeyakumar, McArthur, Muanda, Paterson, Garg), London, Ont.; Division of Nephrology (Parikh), School of Medicine, Johns Hopkins University, Baltimore, Md.; Department of Internal Medicine (Tangri), Max Rady College of Medicine, University of Manitoba; Seven Oaks General Hospital (Tangri), Chronic Disease Innovation Centre, Winnipeg, Man.
Eric McArthurDepartments of Epidemiology and Biostatistics (Iskander, Clemens, Dixon, Jeyakumar, Muanda, Garg), and Medicine (Clemens, Garg), Western University, London, Ont.; Department of Medicine, Division of Nephrology (Cherney), Toronto General Hospital, University of Toronto; Department of Physiology, and Banting and Best Diabetes Centre (Cherney), University of Toronto; Division of Nephrology (Harel, Wald), St. Michael's Hospital; Faculty of Medicine (Udell), University of Toronto; Cardiovascular Division (Udell), Department of Medicine and Women's College Research Institute, Women's College Hospital, Toronto, Ont.; Toronto, Ont.; ICES (Clemens, Dixon, Jeyakumar, McArthur, Muanda, Paterson, Garg), London, Ont.; Division of Nephrology (Parikh), School of Medicine, Johns Hopkins University, Baltimore, Md.; Department of Internal Medicine (Tangri), Max Rady College of Medicine, University of Manitoba; Seven Oaks General Hospital (Tangri), Chronic Disease Innovation Centre, Winnipeg, Man.
Flory Tsobo MuandaDepartments of Epidemiology and Biostatistics (Iskander, Clemens, Dixon, Jeyakumar, Muanda, Garg), and Medicine (Clemens, Garg), Western University, London, Ont.; Department of Medicine, Division of Nephrology (Cherney), Toronto General Hospital, University of Toronto; Department of Physiology, and Banting and Best Diabetes Centre (Cherney), University of Toronto; Division of Nephrology (Harel, Wald), St. Michael's Hospital; Faculty of Medicine (Udell), University of Toronto; Cardiovascular Division (Udell), Department of Medicine and Women's College Research Institute, Women's College Hospital, Toronto, Ont.; Toronto, Ont.; ICES (Clemens, Dixon, Jeyakumar, McArthur, Muanda, Paterson, Garg), London, Ont.; Division of Nephrology (Parikh), School of Medicine, Johns Hopkins University, Baltimore, Md.; Department of Internal Medicine (Tangri), Max Rady College of Medicine, University of Manitoba; Seven Oaks General Hospital (Tangri), Chronic Disease Innovation Centre, Winnipeg, Man.
Chirag R ParikhDepartments of Epidemiology and Biostatistics (Iskander, Clemens, Dixon, Jeyakumar, Muanda, Garg), and Medicine (Clemens, Garg), Western University, London, Ont.; Department of Medicine, Division of Nephrology (Cherney), Toronto General Hospital, University of Toronto; Department of Physiology, and Banting and Best Diabetes Centre (Cherney), University of Toronto; Division of Nephrology (Harel, Wald), St. Michael's Hospital; Faculty of Medicine (Udell), University of Toronto; Cardiovascular Division (Udell), Department of Medicine and Women's College Research Institute, Women's College Hospital, Toronto, Ont.; Toronto, Ont.; ICES (Clemens, Dixon, Jeyakumar, McArthur, Muanda, Paterson, Garg), London, Ont.; Division of Nephrology (Parikh), School of Medicine, Johns Hopkins University, Baltimore, Md.; Department of Internal Medicine (Tangri), Max Rady College of Medicine, University of Manitoba; Seven Oaks General Hospital (Tangri), Chronic Disease Innovation Centre, Winnipeg, Man.
J Michael PatersonDepartments of Epidemiology and Biostatistics (Iskander, Clemens, Dixon, Jeyakumar, Muanda, Garg), and Medicine (Clemens, Garg), Western University, London, Ont.; Department of Medicine, Division of Nephrology (Cherney), Toronto General Hospital, University of Toronto; Department of Physiology, and Banting and Best Diabetes Centre (Cherney), University of Toronto; Division of Nephrology (Harel, Wald), St. Michael's Hospital; Faculty of Medicine (Udell), University of Toronto; Cardiovascular Division (Udell), Department of Medicine and Women's College Research Institute, Women's College Hospital, Toronto, Ont.; Toronto, Ont.; ICES (Clemens, Dixon, Jeyakumar, McArthur, Muanda, Paterson, Garg), London, Ont.; Division of Nephrology (Parikh), School of Medicine, Johns Hopkins University, Baltimore, Md.; Department of Internal Medicine (Tangri), Max Rady College of Medicine, University of Manitoba; Seven Oaks General Hospital (Tangri), Chronic Disease Innovation Centre, Winnipeg, Man.
Navdeep TangriDepartments of Epidemiology and Biostatistics (Iskander, Clemens, Dixon, Jeyakumar, Muanda, Garg), and Medicine (Clemens, Garg), Western University, London, Ont.; Department of Medicine, Division of Nephrology (Cherney), Toronto General Hospital, University of Toronto; Department of Physiology, and Banting and Best Diabetes Centre (Cherney), University of Toronto; Division of Nephrology (Harel, Wald), St. Michael's Hospital; Faculty of Medicine (Udell), University of Toronto; Cardiovascular Division (Udell), Department of Medicine and Women's College Research Institute, Women's College Hospital, Toronto, Ont.; Toronto, Ont.; ICES (Clemens, Dixon, Jeyakumar, McArthur, Muanda, Paterson, Garg), London, Ont.; Division of Nephrology (Parikh), School of Medicine, Johns Hopkins University, Baltimore, Md.; Department of Internal Medicine (Tangri), Max Rady College of Medicine, University of Manitoba; Seven Oaks General Hospital (Tangri), Chronic Disease Innovation Centre, Winnipeg, Man.
Jacob A UdellDepartments of Epidemiology and Biostatistics (Iskander, Clemens, Dixon, Jeyakumar, Muanda, Garg), and Medicine (Clemens, Garg), Western University, London, Ont.; Department of Medicine, Division of Nephrology (Cherney), Toronto General Hospital, University of Toronto; Department of Physiology, and Banting and Best Diabetes Centre (Cherney), University of Toronto; Division of Nephrology (Harel, Wald), St. Michael's Hospital; Faculty of Medicine (Udell), University of Toronto; Cardiovascular Division (Udell), Department of Medicine and Women's College Research Institute, Women's College Hospital, Toronto, Ont.; Toronto, Ont.; ICES (Clemens, Dixon, Jeyakumar, McArthur, Muanda, Paterson, Garg), London, Ont.; Division of Nephrology (Parikh), School of Medicine, Johns Hopkins University, Baltimore, Md.; Department of Internal Medicine (Tangri), Max Rady College of Medicine, University of Manitoba; Seven Oaks General Hospital (Tangri), Chronic Disease Innovation Centre, Winnipeg, Man.
Ron WaldDepartments of Epidemiology and Biostatistics (Iskander, Clemens, Dixon, Jeyakumar, Muanda, Garg), and Medicine (Clemens, Garg), Western University, London, Ont.; Department of Medicine, Division of Nephrology (Cherney), Toronto General Hospital, University of Toronto; Department of Physiology, and Banting and Best Diabetes Centre (Cherney), University of Toronto; Division of Nephrology (Harel, Wald), St. Michael's Hospital; Faculty of Medicine (Udell), University of Toronto; Cardiovascular Division (Udell), Department of Medicine and Women's College Research Institute, Women's College Hospital, Toronto, Ont.; Toronto, Ont.; ICES (Clemens, Dixon, Jeyakumar, McArthur, Muanda, Paterson, Garg), London, Ont.; Division of Nephrology (Parikh), School of Medicine, Johns Hopkins University, Baltimore, Md.; Department of Internal Medicine (Tangri), Max Rady College of Medicine, University of Manitoba; Seven Oaks General Hospital (Tangri), Chronic Disease Innovation Centre, Winnipeg, Man.
Amit X GargDepartments of Epidemiology and Biostatistics (Iskander, Clemens, Dixon, Jeyakumar, Muanda, Garg), and Medicine (Clemens, Garg), Western University, London, Ont.; Department of Medicine, Division of Nephrology (Cherney), Toronto General Hospital, University of Toronto; Department of Physiology, and Banting and Best Diabetes Centre (Cherney), University of Toronto; Division of Nephrology (Harel, Wald), St. Michael's Hospital; Faculty of Medicine (Udell), University of Toronto; Cardiovascular Division (Udell), Department of Medicine and Women's College Research Institute, Women's College Hospital, Toronto, Ont.; Toronto, Ont.; ICES (Clemens, Dixon, Jeyakumar, McArthur, Muanda, Paterson, Garg), London, Ont.; Division of Nephrology (Parikh), School of Medicine, Johns Hopkins University, Baltimore, Md.; Department of Internal Medicine (Tangri), Max Rady College of Medicine, University of Manitoba; Seven Oaks General Hospital (Tangri), Chronic Disease Innovation Centre, Winnipeg, Man.
Toronto Western Hospital · CA
Funding
Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9MNCATS NIH HHS UL1 TR001863
Abstract
backgroundRegulatory agencies warn about the risk of acute kidney injury (AKI) after the initiation of sodium-glucose cotransporter-2 (SGLT2) inhibitors. Our objective was to quantify the 90-day risk of AKI in older adults after initiation of SGLT2 inhibitors in routine clinical practice.
methodsWe conducted a population-based retrospective cohort study in Ontario, Canada, involving adults with diabetes who were aged 66 years or older and who were newly dispensed either an SGLT2 inhibitor or a dipeptidyl peptidase-4 (DPP4) inhibitor in an outpatient setting between 2015 and 2017. We used inverse probability of treatment weighting based on a propensity score to balance the 2 groups on measured baseline characteristics. The primary outcome was 90-day risk of a hospital encounter (i.e., visit to the emergency department or admission to hospital) with AKI, which we defined by a 50% or greater increase in the concentration of serum creatinine from the baseline value or an absolute increase of at least 27 μmol/L after an SGLT2 or DDP4 inhibitor was dispensed. We obtained weighted risk ratios using modified Poisson regression and weighted risk differences using binomial regression.
resultsWe included 39 094 patients with a median age of 70 (interquartile range 68-74) years in the study. Relative to new use of a DPP4 inhibitor, initiation of a SGLT2 inhibitor was associated with a lower 90-day risk of a hospital encounter with AKI: 216 events in 19 611 patients (1.10%) versus 388 events in 19 483 patients (1.99%); weighted risk ratio 0.79 (95% confidence interval 0.64-0.98).
interpretationIn routine care of older adults, new use of SGLT2 inhibitors compared with use of DPP4 inhibitors was associated with a lower risk of AKI. Together with previous evidence, our findings suggest that regulatory warnings about AKI risk with SGLT2 inhibitors are unwarranted.
Indexed as
Acute Kidney InjuryAgedCohort StudiesDiabetes Mellitus, Type 2Dipeptidyl-Peptidase IV InhibitorsHumansHypoglycemic AgentsOntarioRetrospective StudiesRiskSodium-Glucose Transporter 2 InhibitorsDipeptidyl-Peptidase IV InhibitorsHypoglycemic AgentsSodium-Glucose Transporter 2 Inhibitors
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