Journal
JOURNAL OF DIABETES INVESTIGATION
Volume 12, Issue 1, Pages 74-81Publisher
WILEY
DOI: 10.1111/jdi.13318
Keywords
Blood pressure; Diabetic nephropathy; Sodium-glucose cotransporter 2 Inhibitors
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Blood pressure after SGLT2i administration influences renal outcomes in Japanese type 2 diabetes mellitus patients with chronic kidney disease.
Aims/Introduction Sodium-glucose cotransporter 2 inhibitors (SGLT2i) improve renal outcome in patients with type 2 diabetes mellitus, but the mechanism is not fully understood. The aim of this retrospective study was to assess the association of achieved blood pressure with renal outcomes in Japanese type 2 diabetes mellitus patients with chronic kidney disease. Materials and Methods We assessed 624 Japanese type 2 diabetes mellitus patients with chronic kidney disease taking SGLT2i for >1 year. The patients were classified as those with post-treatment mean arterial pressure (MAP) of >= 92 mmHg (n = 344) and those with MAP of <92 mmHg (n = 280) for propensity score matching (1:1 nearest neighbor match with 0.04 of caliper value and no replacement). The end-point was a composite of progression of albuminuria or a decrease in the estimated glomerular filtration rate by >= 15% per year. Results By propensity score matching, a matched cohort model was constructed, including 201 patients in each group. The incidence of renal composite outcome was significantly lower among patients with MAP of <92 mmHg than among patients with MAP of >= 92 mmHg (n = 11 [6%] vsn = 26 [13%], respectively,P = 0.001). The change in estimated glomerular filtration rate was similar in the two groups; however, the change in the albumin-to-creatinine ratio was significantly larger in patients with MAP of <92 mmHg. Conclusions In Japanese type 2 diabetes mellitus patients with chronic kidney disease, blood pressure after SGLT2i administration influences the renal composite outcome. Blood pressure management is important, even during treatment with SGLT2i.
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