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Renal Protection at a Metabolic Cost: A Systematic Review and Meta-Analysis of Perioperative Use of Sodium-Glucose Cotransporter 2 Inhibitors - PubMed

a day ago
  • #SGLT2 inhibitors
  • #perioperative care
  • #renal protection
  • The study examines the perioperative use of SGLT2 inhibitors, balancing risks of diabetic ketoacidosis (DKA) and euglycemic ketoacidosis (eKA) against potential renal protection benefits.
  • A meta-analysis of 10 studies involving 246,242 patients found no significant association between SGLT2 inhibitor use and eKA or DKA in the primary analysis, but sensitivity analysis showed increased risks.
  • SGLT2 inhibitors were associated with significant reductions in mortality (OR 0.73) and acute renal injury (OR 0.68), highlighting their renoprotective effects.
  • Patients on SGLT2 inhibitors had lower perioperative pH, base excess, and blood glucose levels, indicating metabolic changes.
  • The study concludes that while SGLT2 inhibitors offer significant survival and renal benefits, their use requires careful metabolic monitoring due to the latent risk of ketoacidosis.