In a study published in Frontiers in Endocrinology, researchers investigated the effects of three different sodium-glucose cotransporter 2 (SGLT2) inhibitors, or anti-diabetic medications.* The study found beneficial effects on renal (kidney) function from all three medications and in patients with varying stages of chronic kidney disease (CKD). 

Background information

SGLT2 inhibitors, or gliflozins, are a new type of oral anti-diabetic medication for type 2 diabetes, which prevents the kidney from reabsorbing glucose. Healthy kidneys do not secrete glucose into urine, but in CKD patients, these medications allow the body to remove excess glucose through excretion via urine (glycosuria), thus lowering blood sugar levels.

Research and investigation details

Researchers conducted a trial at Chang Gung Memorial Hospital, one of the largest medical institutions in Taiwan, to examine the effects of SGLT2 inhibitors on renal function. The trial aimed to determine if SGLT2 inhibitors have beneficial effects on CKD patients (across different CKD stages) with diabetes.

• The SGLT2 inhibitors, or anti-diabetic medications, tested were empagliflozin and dapagliflozin.
• Empagliflozin was tested both in a dose of 10 mg/tablet (Empa10) and a dose of 25 mg/tablet (Empa25). Dapagliflozin (Dapa) was examined in a dose of 10 mg/tablet. 
• The trial included 7,624 SGLT2 inhibitor users—of which 3,274 patients used Dapa, 1,696 used Empa10, and 2,654 used Empa25. 
• The same number of matched non-users were involved in a control group.

In the trial, the researchers determined the hospitalization rate and glomerular filtration rate (GFR) in both the patients taking SGLT2s and the control group. GFR is a measure of the flow rate of filtered fluid through the kidney.

Results and conclusions

• Compared with non-users, patients taking Dapa had the lowest risk of GFR decrease. 
• Related acute kidney injury (AKI) hospitalization rate was lower in Empa10 and Dapa users than in non-users.
• In all SGLT2 inhibitor users, glycated hemoglobin was reduced. Dapa users had a more significant reduction compared with Empa25 users.
• In addition to reduction in blood glucose, other benefits of SGLT2 inhibitors were found, including both reduced body weight and blood pressure.

In sum, the study found a “lower risk of eGFR decrease over 40% and AKI-related hospitalization” in all patients taking SGLT2 inhibitors no matter what their CKD stage was. Therefore, patients using these anti-diabetic medications will experience renal deterioration at a less-frequent rate.

Additional information can be found in the Endocrinology Advisor article, “SGLT2 Inhibitors Linked to Less Renal Deterioration Across All CKD Stages.”

*Lin, Y-H, Huang, Y-Y, Hsieh, S-H, Sun, J-H, et al. (2019, Nov. 22). “Renal and Glucose-Lowering Effects of Empagliflozin and Dapagliflozin in Different Chronic Kidney Disease Stages.” Frontiers in Endocrinology.