European Journal of Medical Research (Dec 2024)

The association between sodium–glucose cotransporter 2 inhibitors and contrast-associated acute kidney injury in patients with type 2 diabetes undergoing angiography: a propensity-matched study

  • Hao Yang,
  • Lili Yang,
  • Meg J. Jardine,
  • Clare Arnott,
  • Brendon L. Neuen,
  • Kexi Xu,
  • Xiaohui Zhao,
  • Dehui Qian,
  • Bin Cui,
  • Youzhu Qiu,
  • Yuli Huang,
  • Jie Yu,
  • Jiang Wang,
  • Shiyong Yu,
  • Hu Tan,
  • Lan Huang,
  • Jing-Wei Li,
  • Jun Jin

DOI
https://doi.org/10.1186/s40001-024-02214-7
Journal volume & issue
Vol. 29, no. 1
pp. 1 – 11

Abstract

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Abstract Background Sodium–glucose cotransporter-2 inhibitors (SGLT2i) have been proven to prevent decline in kidney function and failure. Whether SGLT2i affect the risk of contrast-associated acute kidney injury (CA-AKI) remains uncertain. Methods Use of SGLT2i was assessed in consecutive diabetics undergoing coronary angiography (CA) or percutaneous coronary intervention (PCI) from January 2020 to May 2023 at a tertiary hospital in Chongqing, China. Propensity-matched analysis was used to adjust for baseline variables. CA-AKI was defined by the Acute Kidney Injury Network (AKIN) as creatinine increase ≥ 0.3 mg/dl (26.4 μmol/l), or a percentage increase in the serum creatinine level of ≥ 50%. Results A total of 604 new users of SGLT2i, and 298 chronic users of SGLT2i were matched with non-users. New use of SGLT2i was not associated with an increased incidence of AKIN-defined CA-AKI (OR 1.60; 95% CI 0.97–2.63; p = 0.065), in-hospital new-onset dialysis (OR 0.50; 95% CI 0.09–2.73; p = 0.422), or death (OR 0.55; 95% CI 0.18–1.66; p = 0.289). However, it was associated with a minor (> 25%) creatinine elevation (OR 1.55; 95% CI 1.04–2.30; p = 0.030), a 0.3 mg/dl increase in creatinine (OR 1.66; 95% CI 1.01–2.75; p = 0.048), and CMSC-defined CA-AKI (OR 1.51; 95% CI 1.02–2.24; p = 0.039). By 90 days, there was no evidence creatinine elevation differed between the two groups (p = 0.590). Chronic use of SGLT2i was not associated with AKIN-defined CA-AKI (OR, 0.92; 95% CI 0.41–2.05; p = 0.838). Conclusions New use of SGLT2i during CA or PCI was not associated with an AKIN-defined CA-AKI, and it did not translate into new-onset dialysis or death during hospital stay. Chronic usage of SGLT2i did not affect creatinine. Further randomized clinical trials are warranted to confirm this finding.

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