Sodium-glucose cotransporter 2 (SGLT2) inhibitors, also known as gliflozins, treat type 2 diabetes by inhibiting reabsorption of glucose in the kidneys, thus lowering blood sugar. A recent study published in the British Medical Journal suggests that this class of diabetes medication may also help reduce the risk of chronic kidney disease (CKD).

Background

Type 2 diabetes is the leading cause of kidney failure. Although clinical trials had demonstrated that SGLT2 inhibitors protect the kidneys in patients with type 2 diabetes, the drugs’ effects on primary kidney functions had not been explored.

What they did

To investigate these effects, a multinational group of researchers and physicians conducted a two-year observational study of patients from Sweden, Denmark, and Norway. The average patient age was 61, and they used national registry data from routine clinical exams.

Two study groups were assembled, one with 29,887 new users of SGLT2 inhibitors and the other with 29,887 new users of dipeptidyl peptidase-4 (DPP-4) inhibitors. 

The data they assessed included:

• use of kidney replacement therapy; 
• hospital admission for kidney disease; and
• mortality due to kidney disease. 

What they found

The study’s results linked the use of SGLT2 inhibitors with a 58% lower risk of serious kidney-related events.

They specifically found that:

• The group of patients treated with SGLT2 inhibitors experienced 2.6 events per 1,000 patients.
• The group of patients treated with DPP-4 inhibitors experienced 6.2 events per 1,000 patients. 

Additional analysis also revealed a risk reduction in patients with underlying cardiovascular disease (CVD) and kidney disease.

What this means

Despite the encouraging results, the findings are limited in terms of generalization, as the study parameters were confined to high-income countries with predominantly Scandinavian populations. 

The study authors acknowledge that further research is necessary with regard to lower-income countries that have more ethnically-diverse populations and higher disease burdens. 

Observational studies are also limited to the available information. This study used prescription data and hospital records, the accuracy of which cannot be verified. 

The original study, “Use of sodium-glucose co-transporter 2 inhibitors and risk of serious renal events: Scandinavian cohort study,” can be found in the British Medical Journal.

*Science Daily. (2020, Apr. 29). “Certain diabetes drugs may protect against serious kidney problems: Findings support use of SGLT2 inhibitors in a broad range of patients with type 2 diabetes.” http://www.sciencedaily.com/releases/2020/04/200429191849.htm