Chronic kidney disease and SGLT2 inhibitors

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Goodfellow Gems

Chronic kidney disease and SGLT2 inhibitors

A July 2022 Tools for Practice notes that some SGLT2 inhibitors were helpful for patients with end-stage renal disease.1

For every 100 patients with chronic kidney disease (CKD) treated with an SGLT2i for 5 years, ~3-4 fewer will develop end-stage kidney disease (ESKD), and ~3-4 fewer will die from any cause compared to placebo.  Sotagliflozin is not better than placebo for these outcomes (not available in NZ; Empagliflozin is currently fully funded for patients with type 2 diabetes in New Zealand who are at high risk of cardiovascular or renal complications). 

The findings were ESKD: 8.9% medication versus 12% (placebo), NNT = 33 and for cardiovascular death: 11% versus 14% (placebo), NNT=27. For overall mortality: 19% versus 22% (placebo), NNT=31.

Reference:

  1. Tools for Practice #319. Should a ‘flozin’ be chosen? Part 2: SGLT2 inhibitors in patients with chronic kidney disease View

Gems are chosen by the Goodfellow director Dr Bruce Arroll to be either practice changing or practice maintaining. The information is educational and not clinical advice.



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