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SGLT2 inhibition in Patients with Type 2 Diabetes and CKD Experiencing a Deterioration in Estimated Glomerular Filtration Rate to <20ml/min/1.73m2 - PubMed

6 hours ago
  • #chronic kidney disease
  • #SGLT2 inhibitors
  • #type 2 diabetes
  • SGLT2 inhibitors are recommended for initiation when eGFR is ≥20ml/min/1.73m² in patients with type 2 diabetes and CKD.
  • Continuation of SGLT2 inhibitors is advised even if eGFR falls below 20ml/min/1.73m², though data on efficacy and safety in this scenario are limited.
  • A post-hoc analysis of the CREDENCE trial evaluated the effects of canagliflozin in patients whose eGFR deteriorated to <20ml/min/1.73m².
  • Among 4,401 participants, 10.1% experienced eGFR deterioration to <20ml/min/1.73m², showing a higher risk of the primary composite outcome.
  • Canagliflozin was associated with a lower risk of the primary outcome, regardless of eGFR deterioration, with no significant interaction effect.
  • Adverse event rates were higher in patients with eGFR <20ml/min/1.73m² but similar between treatment groups.
  • The study supports continuing SGLT2 inhibitors like canagliflozin in patients with eGFR <20ml/min/1.73m², showing persistent benefits for kidney and cardiovascular outcomes without additional safety concerns.