ArticleBMC medicine2022
Predictors of cardio-kidney complications and treatment failure in patients with chronic kidney disease and type 2 diabetes treated with SGLT2 inhibitors.
Article in BMC medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.
- A systematic literature review on the burden of diabetic ketoacidosis in type 2 diabetes mellitus.Diabetes, obesity & metabolism · 2025Pooled it
- Comparative Effectiveness of Once-Weekly Semaglutide Versus Sulfonylureas, DPP4 Inhibitors, and Thiazolidinediones in Patients with Type 2 Diabetes and Chronic Kidney Disease.Advances in therapy · 2026Article
- Predicting Treatment Failure With Sodium-Glucose Cotransporter-2 Inhibitors in People With Type 2 Diabetes: Novel Artificial Intelligence and Machine Learning Approach.JMIR diabetes · 2026Article
- Utilization and clinical characteristics of patients with type 2 diabetes and chronic kidney disease prescribed finerenone in the United States.Journal of clinical & translational endocrinology · 2026Article
- Dapagliflozin vs. Empagliflozin for cardiorenal risk reduction: Real-world paired data and comparative study in Indonesia .F1000Research · 2025Article
- Heat-treated and/or lysozyme-treatedJournal of clinical biochemistry and nutrition · 2024Article
- Risk Prediction and Management of Chronic Kidney Disease in People Living with Type 2 Diabetes Mellitus.Diabetes & metabolism journal · 2024Review
- The inverse association between DNA gaps and HbA1c levels in type 2 diabetes mellitus.Scientific reports · 2023Article
- Decreased Alu methylation in type 2 diabetes mellitus patients increases HbA1c levels.Journal of clinical laboratory analysis · 2023Article
- Development of Osteoarthritis in Adults With Type 2 Diabetes Treated With Metformin vs a Sulfonylurea.JAMA network open · 2023Article
- From screening to treatment: the new landscape of diabetic kidney disease.BMC medicine · 2022Article
- Benefits of SGLT2 inhibitors in arrhythmias.Frontiers in cardiovascular medicine · 2022Review
- SGLT2 inhibitors suppress epithelial-mesenchymal transition in podocytes under diabetic conditionsFrontiers in pharmacology · 2022Article
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Authors and funding
7 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundClinical practice guidelines recommend sodium-glucose co-transporter 2 inhibitors (SGLT2is) to mitigate adverse kidney and cardiovascular outcomes in patients with type 2 diabetes (T2D), including patients with comorbid chronic kidney disease (CKD), also referred to as diabetic kidney disease (DKD), who are at even higher risk. In this study, we sought to identify predictors of cardio-kidney events, cardio-kidney complications, and treatment failure (i.e., addition/initiation of a new T2D class, insulin, or discontinuation of SGLT2is) after new initiation of SGLT2is in patients with CKD and T2D (DKD).
methodsIn this retrospective cohort study, we identified adult patients with DKD who initiated SGLT2is between April 1, 2012, and June 30, 2019, in Optum claims data. Outcome rates per 1000 person-years (PY) are reported with 95% confidence intervals (CIs). Cox proportional hazards regression identified patient characteristics associated with each outcome.
resultsThe study population consisted of 6389 initiators of SGLT2is. The rate of CV hospitalization was 26.0 (95% CI 21.6, 30.4) per 1000 PY. Baseline characteristics associated with higher risk of CV hospitalization included age, atrial fibrillation, peripheral vascular disease (PVD), and cancer. The rate of kidney hospitalization was 12.0 (95% CI 9.0, 15.0) per 1000 PY. The risk increased significantly with baseline evidence of heart failure, hyperkalemia, respiratory failure, depression, and use of loop diuretics. In total, 55.0% of all SGLT2i initiators discontinued treatment during the follow-up period. The rate of treatment failure was 510.5 (95% CI 492.9, 528.1) per 1000 PY. Analysis of key time-dependent SGLT2i-associated adverse events showed that experiencing diabetic ketoacidosis and volume depletion were associated with risk of treatment failure.
conclusionsOur study demonstrated high rates of residual cardio-kidney outcomes and treatment failure in patients with DKD treated with SGLT2is. Patients with high baseline CV risk and the presence of certain conditions, such as atrial fibrillation, PVD, and heart failure, were at higher risk for cardio-kidney events. Further research is needed to assess the potential relationship between adverse events and SGLT2i treatment failure.
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