{
    "abstract": "Studies of sodium-glucose cotransporter-2 (SGLT2) inhibitors assessing kidney outcomes among Asians with type 2 diabetes in a clinical setting are limited. We assessed the association of SGLT2 inhibitors with kidney and safety outcomes in a diverse multiethnic Asian population with type 2 diabetes in a clinical setting.\nRetrospective cohort study.\nPatients with type 2 diabetes from multi-institutional SingHealth Diabetes Registry in Singapore.\nInitiators of SGLT2 inhibitors between 2014 to 2018 with a median follow-up duration of 25.6 months (interquartile range, 17.9-31.4).\nComposite kidney outcome (\u226540% estimated glomerular filtration rate [eGFR] decline or incident kidney failure with replacement therapy [KFRT]), its components, rate of eGFR change, amputation, and acute kidney injury (AKI).\nPropensity scores for SGLT2 inhibitors initiation were developed, with 1:1 matching with initiators of other antidiabetic drugs. Cox proportional hazards and linear mixed effect models were employed.\nAfter matching, there were 4,254 patients newly initiated on either SGLT-2 inhibitors or other glucose-lowering drugs (2,127 in each group). The mean age was 63.4 (SD 9.2) years, with 48.6% women. In total, 67.8% of participants were Chinese, 11.9% Indian, 15.6% Malay, and 4.7% others. Initiating SGLT2 inhibitors was associated with lower risks of composite kidney outcome (hazard ratio [HR], 0.39; 95% CI, 0.31-0.48) and\u00a0\u226540% reduction in eGFR from baseline (HR, 0.38; 95% CI, 0.31-0.48). SGLT2 inhibitor initiation was also associated with a slower eGFR decline among the intention-to-treat population (n\u00a0=\u00a01,888, difference in slope: 2.67\u00a0mL/min per 1.73\u00a0m\nPotential informed presence bias and residual and unmeasured confounding.\nSGLT2 inhibitors significantly benefit kidney outcomes in multiethnic Asians with type 2 diabetes, highlighting their role in preventing kidney complications.\nReal-world evidence on the kidney benefits of sodium-glucose cotransporter-2 (SGLT2) inhibitors among Asians with type 2 diabetes is limited. This study examined the effects of SGLT2 inhibitors on kidney and safety outcomes in a diverse group with type 2 diabetes in Singapore. Data from 2,127 patients initiating SGLT2 inhibitors were matched 1:1 with other glucose-lowering drugs users using propensity scores. Over a median follow-up of 25.6 months, SGLT2 inhibitors were linked to a 61% lower risk of significant kidney function decline and a slower rate of kidney function loss than other glucose-lowering drugs. Importantly, their use did not increase the risk of amputation or acute kidney injury. These findings support their role in kidney protection in Asian populations with diabetes.",
    "authors": [
        {
            "affiliation": "Program in Health Services & Systems Research, Duke-NUS Medical School, Singapore.",
            "firstname": "Liang",
            "initials": "L",
            "lastname": "Feng"
        },
        {
            "affiliation": "Department of Renal Medicine, Singapore General Hospital, Singapore.",
            "firstname": "Zhong Hong",
            "initials": "ZH",
            "lastname": "Liew"
        },
        {
            "affiliation": "Department of Endocrinology, Singapore General Hospital, Singapore.",
            "firstname": "Yong Mong",
            "initials": "YM",
            "lastname": "Bee"
        },
        {
            "affiliation": "Program in Health Services & Systems Research, Duke-NUS Medical School, Singapore.\nDuke Global Health Institute, Durham, NC.",
            "firstname": "Tazeen H",
            "initials": "TH",
            "lastname": "Jafar"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 2025 The Authors.\n\u00a9 2025 The Authors.",
    "doi": "10.1016/j.xkme.2024.100963",
    "journal": "Kidney medicine",
    "keywords": [
        "Sodium-glucose cotransporter-2 inhibitors",
        "estimated glomerular filtration rate",
        "kidney function",
        "longitudinal study",
        "propensity score matching",
        "type 2 diabetes"
    ],
    "methods": null,
    "publication_date": "2025-03-17",
    "pubmed_id": "40092472\n35529086\n27188921\n16936151\n19875164\n34247495\n36700422\n30424892\n33888126\n31495651\n35349656\n37202870\n32502190\n31815931\n33762850\n37330614\n19414839\n25018918\n24461729\n34363037\n20871802\n26501539\n28751576\n34593566\n31862149\n35756732\n32000955\n27470878\n33691091\n32998736\n35330915\n29626204\n33619050\n36582120\n37804691\n34748574\n37153973\n37318416\n35238129\n32744392\n37356446\n35914061\n27852603\n26954351\n20228141",
    "results": "After matching, there were 4,254 patients newly initiated on either SGLT-2 inhibitors or other glucose-lowering drugs (2,127 in each group). The mean age was 63.4 (SD 9.2) years, with 48.6% women. In total, 67.8% of participants were Chinese, 11.9% Indian, 15.6% Malay, and 4.7% others. Initiating SGLT2 inhibitors was associated with lower risks of composite kidney outcome (hazard ratio [HR], 0.39; 95% CI, 0.31-0.48) and\u00a0\u226540% reduction in eGFR from baseline (HR, 0.38; 95% CI, 0.31-0.48). SGLT2 inhibitor initiation was also associated with a slower eGFR decline among the intention-to-treat population (n\u00a0=\u00a01,888, difference in slope: 2.67\u00a0mL/min per 1.73\u00a0m",
    "title": "Sodium-Glucose Cotransporter-2 Inhibitors and Prevention of Adverse Kidney Outcomes in Type 2 Diabetes: A Clinical Multiethnic Asian Cohort.",
    "xml": "<Element 'PubmedArticle' at 0x788505e3f5b0>"
}