Kidney Diseases · Published 2025-12-30 · DOI 10.1159/000550222
<p>Introduction: Although large randomized control trials have established the renal benefits of sodium-glucose cotransporter-2 inhibitors (SGLT2is) in chronic kidney disease (CKD), real-world evidence in Chinese CKD populations remains scarce. Here we report a multicenter real-world retrospective cohort study of SGLT2i use in hospitalized CKD patients in China. Methods: We enrolled 155,053 adults with CKD from the China Renal Data System (CRDS) databases (January 2002–January 2023). We included patients treated with SGLT2i for at least 3 months. SGLT2i users and nonusers were matched (1:2) using propensity score matching (PSM). The main outcomes included renal, safety, and clinical outcomes. Renal outcomes included the first occurrence of CKD progression, end-stage kidney disease (ESKD), or composite outcomes. Multivariable Cox regression models and cumulative incidence were estimated post-PSM. Results: Overall, the core analysis included 1,477 SGLT2i users and 2,674 nonusers. The progression of CKD (HR 0.81, 95% confidence interval [CI] 0.69–0.95, p < 0.01), incidence of ESKD (HR 0.26, 95% CI 0.18–0.37, p < 0.001), and composite renal outcome (HR 0.68, 95% CI 0.59–0.77, p < 0.001) were significantly lower in the SGLT2i group compared to the non-SGLT2i group. Additionally, the SGLT2i group experienced lower rates of heart failure, stroke, transient ischemic attack, and severe hypoglycemia but a higher risk of acute pancreatitis compared to the non-SGLT2i group. Additionally, eGFR remains better preserved over 3 years in CKD patients treated with SGLT2i. Conclusion: These findings suggest that SGLT2i offers substantial renal and cardiovascular benefits for Chinese CKD patients. </p>
Abstract from DOAJ. Public domain (CC0 1.0).
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